Applying the Health Belief Model to cervical cancer screening uptake among women in Ethiopia: a systematic review and meta-analysis

Abstract

Background: Cervical cancer is a leading cause of cancer mortality globally, especially in Africa, including Ethiopia. This review assesses predictors of cervical cancer screening uptake among Ethiopian-eligible women using the Health Belief Model. Higher education levels, perceived susceptibility, severity, and fewer barriers are associated with increased screening. Effective HBM-based interventions could enhance screening rates, potentially reducing cervical cancer incidence and mortality. Objective: The review aimed to synthesize the existing literature on the prevalence of Cervical Cancer Screening Service Uptake and Associated Factors among Eligible Women using the Health belief model in Ethiopia, 2024. Method: This systematic review and meta-analysis searched Google Scholar, PubMed, and the Cochrane Library engine. Key terms such as "Cervical cancer screening", "uptake", "utilization", "factors", "barriers", and "Ethiopia" were used to identify relevant articles. Data extraction utilized a detailed form, and the methodological quality of each study was assessed using the JBI quality appraisal checklist for cross-sectional studies. Statistical analysis was conducted using STATA version 17, and the meta-analysis findings were presented using forest plots and tables. Result: The result of seven studies revealed that the overall prevalence of Cervical Cancer Screening Service Uptake among eligible women in Ethiopia was 21% (95% CI: 15%-27%). Factors independently associated with Cancer Screening Service Uptake included: Knowledge (OR = 4.563, 95% CI: 1.012–4.188), age 30 up to 49 (OR = 4.106, 95% CI: 1.562–6.650), history of STD (OR = 2.59, 95% CI: 1.694–4.486), high perceived susceptibility (OR = 3.814, 95% CI: 2.312–5.316), high perceived severity (OR = 2.603, 95% CI: 2.203–3.003), low perceived barrier (OR = 4.390, 95% CI: 1.331–8.449), high perceived self-efficacy (OR = 4.77, 95% CI: 4.102–5.431), high perceived benefit (OR = 3.67, 95% CI: 1.851–5.489), and education level greater than primary level (OR = 4.497, 95% CI: 3.619–5.375). Conclusion: Cervical cancer is a major public health challenge in Ethiopia. Consequently, there is a pressing need for the governments to formulate comprehensive, multi-sectorial policies and strategies. These initiatives should be designed to address the problem influenced by interconnected factors, to reduce the prevalence of cervical cancer in Ethiopia.