{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:18:28Z","timestamp":1785424708604,"version":"3.56.0"},"reference-count":40,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Cervical cancer (CC) remains a leading cause of cancer-related deaths among women in sub-Saharan Africa. In rural Kenya, screening uptake is particularly low, partly because of limited access to reliable health information and other structural barriers such as the unavailability of screening equipment and the cost of screening.\nAim:\u00a0To examine the relationship between access to CC information and screening uptake, and to identify information needs, preferences and dissemination strategies among women with low educational attainment in resource-limited rural settings.\nSetting:\u00a0Rural communities in Bomet and Kericho Counties, Kenya.\nMethods:\u00a0We conducted a mixed methods study among 174 women recruited through purposive convenience sampling. Data collection involved interviewer-administered cross-sectional surveys and semi-structured interviews (n\u00a0= 21). Quantitative data were analysed using logistic regression, and qualitative data using thematic analysis. Findings were integrated during interpretation.\nResults:\u00a0Participants had a mean age of 45 years; 88.5% were from low-income households. Although 82.2% had heard of CC \u2013 primarily via news media (36.8%), health workers (24.1%) and social networks (21.3%) \u2013 only 6.3% had been screened. Health workers and the radio were the most trusted information sources. Access to each additional information source was associated with 4.66 times higher odds of screening (95% confidence interval: 1.19\u201318.25). Despite this, 92% felt inadequately informed. Integrated findings underscored the need for culturally relevant, literacy-sensitive approaches.\nConclusion:\u00a0Screening uptake remains low but improves with exposure to diverse, trusted information sources.\nContribution:\u00a0This study highlights the importance of tailored, community-based strategies to enhance CC screening in underserved rural populations.<\/jats:p>","DOI":"10.4102\/jphia.v17i1.1457","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T07:37:53Z","timestamp":1769413073000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cervical cancer information access and dissemination strategies among rural Kenyan women: A mixed methods study"],"prefix":"10.4102","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2273-418X","authenticated-orcid":false,"given":"Joyline","family":"Chepkorir","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0958-1580","authenticated-orcid":false,"given":"Lucy","family":"Kivuti-Bitok","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02y9nww90","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Nairobi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2025-6543","authenticated-orcid":false,"given":"Nancy","family":"Perrin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Johns Hopkins 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Prevalence and determinants of cervical cancer awareness among women of reproductive age: Evidence from Benin and Zimbabwe population-based data. Appl Cancer Res. 2020;40(1):8. https:\/\/doi.org\/10.1186\/s41241-020-00092-z","DOI":"10.1186\/s41241-020-00092-z"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Mwenda V, Mburu W, Bor JP, et al. Cervical cancer programme, Kenya, 2011\u20132020: Lessons to guide elimination as a public health problem. Ecancermedicalscience. 2022;16:1442. https:\/\/doi.org\/10.3332\/ecancer.2022.1442","DOI":"10.3332\/ecancer.2022.1442"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Campos NG, Sharma M, Clark A, Kim JJ, Resch SC. Resources required for cervical cancer prevention in low- and middle-income countries. PLoS One. 2016;11(10):e0164000. https:\/\/doi.org\/10.1371\/journal.pone.0164000","DOI":"10.1371\/journal.pone.0164000"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Jedy-Agba E, Joko WY, Liu B, et al. Trends in cervical cancer incidence in sub-Saharan Africa. Br J Cancer. 2020;123(1):148\u2013154. https:\/\/doi.org\/10.1038\/s41416-020-0831-9","DOI":"10.1038\/s41416-020-0831-9"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Bruni L, Saura-L\u00e1zaro A, Montoliu A, et al. HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010\u20132019. Prev Med (Baltim). 2021;144:106399. https:\/\/doi.org\/10.1016\/j.ypmed.2020.106399","DOI":"10.1016\/j.ypmed.2020.106399"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Hailegebireal AH, Bizuayehu HM, Tirore LL. Far behind 90-70-90\u2019s screening target: The prevalence and determinants of cervical cancer screening among sub-Saharan African women: Evidence from Demographic and Health Survey. BMC Cancer. 2024;24(1): 1050. https:\/\/doi.org\/10.1186\/s12885-024-12789-3","DOI":"10.1186\/s12885-024-12789-3"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Sauvaget C, Selmouni F, Dangbemey DP, et al. Scaling-up cervical cancer screening and treatment in sub-Saharan Africa: Perspectives from local health policymakers. JCO Glob Oncol. 2023;9:e2300115. https:\/\/doi.org\/10.1200\/GO.23.00115","DOI":"10.1200\/GO.23.00115"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Lim JNW, Ojo AA. Barriers to utilisation of cervical cancer screening in sub-Sahara Africa: A systematic review. Eur J Cancer Care (Engl). 2017;26(1):e12444. https:\/\/doi.org\/10.1111\/ecc.12444","DOI":"10.1111\/ecc.12444"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Binka C, Nyarko SH, Awusabo-Asare K, Doku DT. Barriers to the uptake of cervical cancer screening and treatment among rural women in Ghana. Biomed Res Int. 2019;2019:6320938. https:\/\/doi.org\/10.1155\/2019\/6320938","DOI":"10.1155\/2019\/6320938"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Louie KS, De Sanjose S, Mayaud P. Epidemiology and prevention of human papillomavirus and cervical cancer in sub-Saharan Africa: A comprehensive review. Trop Med Int Health. 2009;14(10):1287\u20131302. https:\/\/doi.org\/10.1111\/j.1365-3156.2009.02372.x","DOI":"10.1111\/j.1365-3156.2009.02372.x"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Morema EN, Atieli HE, Onyango RO, Omondi JH, Ouma C. Determinants of cervical screening services uptake among 18\u201349 year old women seeking services at the Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, Kenya. BMC Health Serv Res. 2014;14(1):335. https:\/\/doi.org\/10.1186\/1472-6963-14-335","DOI":"10.1186\/1472-6963-14-335"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Rosser JI, Hamisi S, Njoroge B, Huchko MJ. Barriers to cervical cancer screening in rural Kenya: Perspectives from a provider survey. J Community Health. 2015;40(4):756\u2013761. https:\/\/doi.org\/10.1007\/s10900-015-9996-1","DOI":"10.1007\/s10900-015-9996-1"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Buchanan Lunsford N, Ragan K, Lee Smith J, Saraiya M, Aketch M. Environmental and psychosocial barriers to and benefits of cervical cancer screening in Kenya. Oncologist. 2017;22(2):173\u2013181. https:\/\/doi.org\/10.1634\/theoncologist.2016-0213","DOI":"10.1634\/theoncologist.2016-0213"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Rosser JI, Njoroge B, Huchko MJ. Cervical cancer stigma in rural Kenya: What does HIV have to do with it? J Cancer Educ. 2016;31(2):413\u2013418. https:\/\/doi.org\/10.1007\/s13187-015-0843-y","DOI":"10.1007\/s13187-015-0843-y"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Jatho A, Everd Bikaitwoha M, Mugume Mugisha N. Socio-culturally mediated factors and lower level of education are the main influencers of functional cervical cancer literacy among women in Mayuge, Eastern Uganda. Ecancer. 2020;14:1004. https:\/\/doi.org\/10.3332\/ecancer.2020.1004","DOI":"10.3332\/ecancer.2020.1004"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Bawuah A, Wang VQ, Adeleye K, Ameyaw EK, Yaya S. Mass media exposure and cervical cancer screening in rural sub-Saharan Africa: A multi-country cross-sectional analysis. Health Sci Rep. 2025;8(4):e70663. https:\/\/doi.org\/10.1002\/hsr2.70663","DOI":"10.1002\/hsr2.70663"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Squiers L, Peinado S, Berkman N, Boudewyns V, McCormack L. The Health Literacy Skills framework. J Health Commun. 2012;17(Suppl. 3):30\u201354. https:\/\/doi.org\/10.1080\/10810730.2012.713442","DOI":"10.1080\/10810730.2012.713442"},{"key":"ref17","unstructured":"Kenya National Bureau of Statistics (KNBS). 2019 Kenya population and housing census, volume II: Distribution of population by administrative units [homepage on the Internet]. 2019 [cited 2025 Apr 30]. Available from: https:\/\/www.knbs.or.ke\/wp-content\/uploads\/2023\/09\/2019-Kenya-population-and-Housing-Census-Volume-2-Distribution-of-Population-by-Administrative-Units.pdf"},{"key":"ref18","unstructured":"Labflow Kenya. Health facilities in Kericho County [homepage on the Internet]. 2022 [cited 2025 Apr 30]. Availalble from: https:\/\/labflow.org\/health-facilities-in-kericho-county\/"},{"key":"ref19","unstructured":"Kinyanjui M. Cabinet clears hospital projects in Bungoma, Kericho to boost UHC rollout [serial online]. The Eastleigh Voice. 2025 [cited 2025 Apr 30]; April 29. Available from: https:\/\/eastleighvoice.co.ke\/health\/143990\/cabinet-clears-hospital-projects-in-bungoma-kericho-to-boost-uhc-rollout"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Odini S. Accessibility and utilization of health information by rural women in Vihiga County, Kenya. Int J Sci Res. 2016;5(7):827\u2013834. https:\/\/doi.org\/10.21275\/NOV164666","DOI":"10.21275\/v5i7.NOV164666"},{"key":"ref21","unstructured":"Bii HK, Otike J. Provision and accessibility of health information to the rural communities in Kenya: A case study of Bomet District. Afr J Libr Arch Inform Sci [serial online]. 2004 [cited 2025 Apr 30];13(2):155\u2013174. Available from: https:\/\/www.ajol.info\/index.php\/ajlais\/article\/view\/26137"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Maree JE, Moitse KA. Exploration of knowledge of cervical cancer and cervical cancer screening amongst HIV-positive women. Curationis. 2014;37(1): 1209. https:\/\/doi.org\/10.4102\/curationis.v37i1.1209","DOI":"10.4102\/curationis.v37i1.1209"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Adedimeji A, Ajeh R, Pierz A, et al. Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context. BMC Womens Health. 2021;21(1):74. https:\/\/doi.org\/10.1186\/s12905-021-01211-w","DOI":"10.1186\/s12905-021-01211-w"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Abril EP, Kupczyk M, Zwicke GL, Mastarone GL, Irwin T, Dykens A. Mapping the health communication infrastructure in rural Senegal: An assessment to support cervical cancer screening. J Appl Commun Res. 2015;43(2):242\u2013262. https:\/\/doi.org\/10.1080\/00909882.2015.1019545","DOI":"10.1080\/00909882.2015.1019545"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Cudjoe J, Gallo JJ, Sharps P, Budhathoki C, Roter D, Han HR. The role of sources and types of health information in shaping health literacy in cervical cancer screening among African immigrant women: A mixed-methods study. Health Lit Res Pract. 2021;5(2):e96\u2013e108. https:\/\/doi.org\/10.3928\/24748307-20210322-01","DOI":"10.3928\/24748307-20210322-01"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Marimwe C, Dowse R. Health literacy test for limited literacy populations (HELT-LL): Validation in South Africa. Cogent Med. 2019;6(1):1650417. https:\/\/doi.org\/10.1080\/2331205X.2019.1650417","DOI":"10.1080\/2331205X.2019.1650417"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Taber KS. The use of Cronbach\u2019s alpha when developing and reporting research instruments in science education. Res Sci Educ. 2018;48(6):1273\u20131296. https:\/\/doi.org\/10.1007\/s11165-016-9602-2","DOI":"10.1007\/s11165-016-9602-2"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Ruddies F, Gizaw M, Teka B, et al. Cervical cancer screening in rural Ethiopia: A cross- sectional knowledge, attitude and practice study. BMC Cancer. 2020;20(1):563. https:\/\/doi.org\/10.1186\/s12885-020-07060-4","DOI":"10.1186\/s12885-020-07060-4"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Ng\u2019ang\u2019a A, Nyangasi M, Nkonge NG, et al. Predictors of cervical cancer screening among Kenyan women: Results of a nested case-control study in a nationally representative survey. BMC Public Health. 2018;18(S3):1221. https:\/\/doi.org\/10.1186\/s12889-018-6054-9","DOI":"10.1186\/s12889-018-6054-9"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Fleiss JL, Levin B, Paik MC. Statistical methods for rates and proportions. Hoboken, NJ: Wiley; 2003.","DOI":"10.1002\/0471445428"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Ryan TP. Sample size determination and power. Hoboken, NJ: Wiley; 2013.","DOI":"10.1002\/9781118439241"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77\u2013101. https:\/\/doi.org\/10.1191\/1478088706qp063oa","DOI":"10.1191\/1478088706qp063oa"},{"key":"ref33","unstructured":"Creswell JW, Clark VLP. Designing and conducting mixed methods research. 3rd ed. Thousand Oaks, CA: SAGE Publications; 2017."},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Bishwajit G, Kpoghomou MA. Urban-rural differentials in the uptake of mammography and cervical cancer screening in Kenya. J Cancer Policy. 2017;12:43\u201348. https:\/\/doi.org\/10.1016\/j.jcpo.2017.03.005","DOI":"10.1016\/j.jcpo.2017.03.005"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Ba DM, Ssentongo P, Musa J, et al. Prevalence and determinants of cervical cancer screening in five sub-Saharan African countries: A population-based study. Cancer Epidemiol. 2021;72:101930. https:\/\/doi.org\/10.1016\/j.canep.2021.101930","DOI":"10.1016\/j.canep.2021.101930"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Endalew DA, Moti D, Mohammed N, Redi S, Wassihun Alemu B. Knowledge and practice of cervical cancer screening and associated factors among reproductive age group women in districts of Gurage zone, Southern Ethiopia. A cross-sectional study. PLoS One. 2020;15(9):e0238869. https:\/\/doi.org\/10.1371\/journal.pone.0238869","DOI":"10.1371\/journal.pone.0238869"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"O\u2019Donovan J, O\u2019Donovan C, Nagraj S. The role of community health workers in cervical cancer screening in low-income and middle-income countries: A systematic scoping review of the literature. BMJ Glob Health. 2019;4(3):e001452. https:\/\/doi.org\/10.1136\/bmjgh-2019-001452","DOI":"10.1136\/bmjgh-2019-001452"},{"key":"ref38","unstructured":"The Johnson & Johnson Foundation. Professional community health workers in Kenya are helping to achieve universal health coverage and support patients. [homepage on the Internet]. 2023 [cited 2023 Dec 11]. Available from: https:\/\/www.jnj.com\/global-health-equity\/professional-community-health-workers-in-kenya-are-helping-to-achieve-universal-health-coverage-and-support-patients"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"Risi L. Media interventions to increase cervical screening uptake in South Africa: An evaluation study of effectiveness. Health Educ Res. 2004; 19(4):457\u2013468. https:\/\/doi.org\/10.1093\/her\/cyg044","DOI":"10.1093\/her\/cyg044"}],"container-title":["Journal of Public Health in Africa"],"original-title":[],"link":[{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/view\/1457\/2688","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T07:38:01Z","timestamp":1769413081000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/view\/1457"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,27]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/jphia.v17i1.1457","relation":{},"ISSN":["2038-9922","2038-9930"],"issn-type":[{"value":"2038-9922","type":"print"},{"value":"2038-9930","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,27]]},"article-number":"a1457"}}