KNOWLEDGE, ATTITUDE, AND PRACTICE REGARDING CERVICAL CANCER AND ITS PREVENTION AMONG ANTENATAL ATTENDEES IN UGBOR PRIMARY HEALTH CARE CENTER, BENIN CITY

TOPIC: KNOWLEDGE, ATTITUDE, AND PRACTICE REGARDING CERVICAL CANCER AND ITS PREVENTION AMONG ANTENATAL ATTENDEES IN UGBOR PRIMARY HEALTH CARE CENTER, BENIN CITY

TOPIC IS SUITABLE FOR:
1-Department of Nursing Science
2-Department of Public Health
3-Department of Health Education
4-Department of Community Health
This research material contains:
1-Chapter One to Five
2-Recent References/citations
3-Tables/Charts/Graphs in Chapter Four
4-Accurate Data Analysis
5-Table of Contents
6-Questionnare

ABSTRACT
This study was carried out to examine the knowledge, attitude, and practice regarding cervical cancer and its prevention among antenatal attendees in Ugbor Primary Health Care Center, Benin City. The study was specifically carried out to assess the level of knowledge of cervical cancer among antenatal attendees at Ugbor Primary Healthcare Center, determine the attitude of antenatal attendees towards cervical cancer and its prevention, and assess the preventive practices of antenatal attendees regarding cervical cancer prevention. The study employed the descriptive survey research design. A total population of 250 antenatal attendees in Ugbor Primary Health Care Center, Benin City was used for the study. A sample size of 154 respondents was determined using Taro Yamane formula, while 139 validated questionnaires were used for analysis. The respondents were selected using multi-stage sampling technique involving stratified and convenience sampling methods. Hence, the questionnaire was used for data collection, while the data collected were analyzed using frequency tables and percentages. The hypothesis test was conducted using Cross Sectional Chi-square statistical tool. From the responses obtained and analyzed, the findings revealed that antenatal attendees had a moderate level of knowledge of cervical cancer, with majority responses ranging from 23.0% to 33.1% across knowledge variables. The study also showed that respondents demonstrated a moderate positive attitude towards cervical cancer and its prevention, with dominant responses ranging from 24.5% to 34.5% across attitude variables. Likewise, the study further revealed that respondents had a moderate level of preventive practices regarding cervical cancer prevention, with majority responses ranging from 20.1% to 33.1% across preventive practice variables. The hypothesis testing revealed that there was a significant relationship between knowledge of cervical cancer and preventive practices among antenatal attendees at Ugbor Primary Healthcare Center at χ² = 29.84, df = 1, P = .000. The study therefore recommends that healthcare providers should intensify health education on cervical cancer, government should strengthen screening and vaccination programs, and women should be encouraged to adopt preventive health practices for early detection and prevention of cervical cancer.
Keywords: Cervical Cancer, Knowledge, Attitude, Preventive Practices, Antenatal Attendees.

CHAPTER ONE
INTRODUCTION (Preview)
1.1 Background to the Study
Cervical cancer is one of the leading causes of cancer-related morbidity and mortality among women worldwide. According to the World Health Organization (2023), cervical cancer is the fourth most common cancer among women globally, with the highest burden occurring in low- and middle-income countries, especially in sub-Saharan Africa. Persistent infection with Human Papillomavirus (HPV) has been identified as the major cause of cervical cancer. The disease develops gradually through precancerous stages, making early detection and prevention very important.
Globally, cervical cancer accounts for a significant number of deaths among women every year. The World Health Organization (2023) reported that more than 90% of cervical cancer deaths occur in developing countries due to poor access to screening and treatment services. Sankaranarayanan et al., (2016) noted that the high burden of cervical cancer in developing countries is associated with lack of awareness, inadequate screening programmes, poverty, poor healthcare infrastructure, and limited access to preventive healthcare services.
In developed countries such as the United States, the incidence and mortality rate of cervical cancer have reduced significantly due to organized screening programmes and early treatment of precancerous lesions. According to Wingo et al., (2013), the introduction of the Papanicolaou smear test, popularly known as the Pap smear test, contributed greatly to the reduction in cervical cancer deaths by more than 70% since the 1950s. Similarly, Kitchener et al., (2017) observed that countries with effective cervical cancer screening programmes have experienced substantial declines in both incidence and mortality rates.
The Centers for Disease Control and Prevention recommends (2024) HPV vaccination for adolescents and regular screening for women aged 21 to 65 years as key strategies for prevention and early detection. Despite these recommendations and the availability of preventive measures such as Pap smear testing, HPV vaccination, screening services, and health education, the uptake of cervical cancer preventive services remains low in many developing countries, including Nigeria. Ezechi et al., (2013) reported that many Nigerian women have poor knowledge of cervical cancer, its risk factors, symptoms, and preventive measures. The authors further stated that low awareness, fear of diagnosis, cultural beliefs, financial challenges, and poor accessibility to healthcare facilities contribute to low uptake of cervical cancer screening services among women.
A study conducted by Ngozi Udigwe (2016) among female nurses at Nnamdi Azikiwe University Teaching Hospital, Nnewi, revealed that although knowledge of cervical cancer prevention was relatively high, the practice and uptake of cervical cancer screening were still very poor. This finding suggests that knowledge alone may not necessarily translate into positive preventive practices among women.
Antenatal clinics provide an important avenue for educating women on reproductive health issues, including cervical cancer prevention. Pregnant women attending antenatal care services are expected to receive adequate health information that can improve their knowledge, attitude, and preventive practices regarding cervical cancer. Therefore, this study seeks to assess the knowledge, attitude, and practice of cervical cancer and its prevention among antenatal attendees at Ugbor Primary Healthcare Center. The findings of this study may contribute to improved awareness, increased screening practices, and better preventive healthcare services among women in the community.

1.2 Statement of problem 
Cervical cancer continues to have a devastating impact on women’s health globally and remains one of the leading causes of cancer-related deaths among women, particularly in developing countries such as Nigeria. According to the World Health Organization (2023), cervical cancer is the fourth most common cancer among women worldwide, with an estimated 604,000 new cases and about 342,000 deaths annually. More than 85% of these deaths occur in low- and middle-income countries due to late diagnosis and poor access to screening and treatment services.
In Nigeria, cervical cancer remains a major public health concern. The World Health Organization (2023) and International Agency for Research on Cancer (IARC) estimated that Nigeria records approximately 12,000–14,000 new cases of cervical cancer annually, with about 8,000–10,000 deaths each year. It is also projected that if no effective intervention is implemented, the number of cases may continue to rise due to increasing population and low screening coverage.
Nigeria is the most populous country in Africa, with over 180 million people. Women aged 15–49 years constitute approximately 40–45 million of the population and are at risk of developing cervical cancer(National population commission [NPC], 2016). This large at-risk population makes cervical cancer a significant reproductive health issue in the country.
Studies have shown that the high burden of cervical cancer in Nigeria is strongly linked to poor knowledge, low awareness, and poor uptake of preventive services among women. Ezechi et al., (2013) reported that many Nigerian women have inadequate knowledge of cervical cancer and its prevention, which contributes to late presentation and high mortality rates. Similarly, Sankaranarayanan et al., (2016) noted that lack of organized screening programs, poverty, and limited access to healthcare services are major barriers to cervical cancer prevention in developing countries.
Although cervical cancer is preventable through screening methods such as the Pap smear test, HPV testing, and vaccination, uptake of these services remains very low in Nigeria. Udigwe (2016) found that even among health workers, awareness of cervical cancer prevention may be high, but actual screening practice remains poor, indicating a gap between knowledge and practice.
Antenatal clinics provide an important opportunity for health education and preventive interventions, as pregnant women regularly interact with healthcare professionals. However, despite these opportunities, many antenatal attendees may still lack adequate knowledge, positive attitude, and appropriate preventive practices regarding cervical cancer.
Furthermore, there is limited documented evidence on the knowledge, attitude, and practice of cervical cancer and its prevention among antenatal attendees at Ugbor Primary Healthcare Center. This creates a gap in information needed to design effective interventions to improve cervical cancer prevention among women in the study area.
This study is supported by the Theory of Planned Behavior (TPB) developed by Icek Ajzen. The theory explains that an individual’s health behavior is influenced by their attitude toward the behavior, subjective norms, and perceived behavioral control. In relation to cervical cancer prevention, women who possess adequate knowledge and positive attitudes toward screening and vaccination are more likely to engage in preventive practices such as Pap smear testing, HPV vaccination, and regular health check-ups. The theory therefore provides a suitable framework for understanding how knowledge and attitude may influence the preventive practices of antenatal attendees regarding cervical cancer.
If this problem is not properly addressed, cervical cancer-related morbidity and mortality among women may continue to increase despite available preventive measures.
Therefore, this study seeks to assess the knowledge, attitude, and practice of cervical cancer and its prevention among antenatal attendees in the study area.
1.3 Objectives of the Study
Broad Objective
The broad objective of this study is to assess the knowledge, attitude, and practice of cervical cancer and its prevention among antenatal attendees at Ugbor Primary Healthcare Center.
Specific Objectives
The specific objectives of the study are to:
1. Assess the level of knowledge of cervical cancer among antenatal attendees at Ugbor Primary Healthcare Center.
2. Determine the attitude of antenatal attendees towards cervical cancer and its prevention.
3. Assess the preventive practices of antenatal attendees regarding cervical cancer prevention.
OTHER PARTS OF CHAPTER ONE INCLUDE:
1.4 Research Questions
1.5 Research Hypotheses
1.6 Significance of the Study
1.7 Scope of the Study
1.8 Definition of Terms

CHAPTER TWO
REVIEW OF LITERATURE (Preview)
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps. This chapter, therefore, focuses on the concept of cervical cancer, causes and risk factors of cervical cancer, signs and symptoms of cervical cancer, knowledge and attitude towards cervical cancer, preventive measures against cervical cancer, and the practice of cervical cancer prevention among antenatal attendees etc. The chapter is sub-grouped into the following major headings:
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Summary of Literature Review

CHAPTER THREE
METHODOLOGY (Preview)
Presented below is a snapshot of key areas of the study methodology, the full and detail chapter three methodology is contained in the instant download document.

Research Design: The study adopted a descriptive research design.
Population of the Study: The population of the study comprises all antenatal attendees receiving care at Ugbor Primary Health Care Center, Benin City, Edo State, with a total population of attendees.
Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 154 participants.
Sampling Technique: The study employed a multi-stage sampling technique involving stratified and convenience sampling methods to select the individual respondents.
Research Instrument: The study utilized a structured questionnaire titled “Knowledge, Attitude, and Practice Regarding Cervical Cancer and Its Prevention among Antenatal Attendees in Ugbor Primary Health Care Center, Benin City” as the instrument for data collection.
Methods of Data Analysis: The collected data were analyzed using frequencies and percentages to summarize and present the demographic characteristics of the respondents and their responses. Inferential statistics, such as Cross-Sectional Chi-square, were used to test the hypotheses.
Full outline for chapter three;
3.1 Research Design
3.2 Research Setting
3.3 Target Population
3.4 Sample Size
3.5 Sampling Technique
3.6 Instruments For Data Collection
3.7 Validity and Reliability of Instrument
3.8 Pilot Study
3.9 Method of Data Collection
3.10 Method Of Data Analysis
3.11 Ethical considerations

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS
MAJOR FINDINGS (Preview)
The analysis results were presented in tables and charts. Based on the results obtained from the analysis, the following major findings were made:

i. The study found that antenatal attendees at Ugbor Primary Healthcare Center, Benin City, have a moderate level of knowledge of cervical cancer, as evidenced by their responses to the six questionnaire items, which showed varying levels of awareness and understanding of cervical cancer, its risk factors, warning signs, early detection, screening and vaccination.

ii. The study found that antenatal attendees at Ugbor Primary Healthcare Center, Benin City, demonstrate a moderate positive attitude towards cervical cancer and its prevention, as evidenced by their responses indicating acceptance of the importance of regular screening, willingness to seek medical advice, and recognition of the role of health education in cervical cancer prevention.

iii. The study found that antenatal attendees at Ugbor Primary Healthcare Center, Benin City, demonstrate a moderate level of preventive practices regarding cervical cancer prevention, as evidenced by their responses on seeking medical information, personal hygiene, willingness to participate in health education programmes, and attitudes towards screening and vaccination.

iv. The study found that there is a significant relationship between the level of knowledge of cervical cancer and preventive practices among antenatal attendees at Ugbor Primary Healthcare Center, Benin City. The corresponding hypothesis test further showed a Chi-square value (χ²) of 29.84, degree of freedom (df) of 1, and p-value of 0.000 (p < 0.05), leading to the rejection of the null hypothesis.

CHAPTER FIVE:DISCUSSION OF FINDINGS
This chapter covers the following outline:
5.4 Summary 
5.5 Conclusion
5.6 Recommendations
5.7 Suggestions for Further Studies
Reference
Appendix

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