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Does introduction of user fees affect the utilization of cervical cancer screening services in Nigeria?

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Background: Screening for cervical cancer improves outcome. This comes at an economic price which some may not be able to afford. Objective: To evaluate the influence of user fees on… Click to show full abstract

Background: Screening for cervical cancer improves outcome. This comes at an economic price which some may not be able to afford. Objective: To evaluate the influence of user fees on the utilization of cervical cancer screening services in Port Harcourt. Materials and Methods: A cross sectional study of clients presenting for cervical cancer screening. Data on the number, socio-demographic characteristics, distance from screening center following 1 month of free cancer screening and 7 months of user fee introduction, was collated and analyzed using SPSS version 20 statistical software. Results are presented in percentages, tables and charts with test of significance set at P < 0.05. Results: Of the 167 women who presented for cervical cancer screening during the study period, the mean age was 42.08 ± 8.9 years and range was 20–70 years. The average parity of patients was 2.83 ± 2.24. Clients' utilization of cervical cancer screening facilities was negatively affected by the introduction of user fees P < 0.001). There is no association between the distance of patients' home from the hospital and the utilization of facility (X2 = 0.24, P = 0.887). There was sustained decrease in number of clients with the introduction of fees. Conclusion: The introduction of user fees had a negative impact on the utilization of cervical cancer screening facilities. Eradicating user fee and improving the socioeconomic status of patients may improve the utilization of screening services.

Keywords: introduction; cancer screening; user fees; cervical cancer; utilization cervical; cancer

Journal Title: Nigerian Journal of Clinical Practice
Year Published: 2019

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