Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis
Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening service has been consistently show...
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| Veröffentlicht in: | PloS one 2021-11, Vol.16 (11), p.e0259339-e0259339 |
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| creator | Desta, Melaku Getaneh, Temesgen Yeserah, Bewuket Worku, Yichalem Eshete, Tewodros Birhanu, Molla Yigzaw Kassa, Getachew Mullu Adane, Fentahun Yeshitila, Yordanos Gizachew |
| description | Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening service has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. Despite this, there are limited studies in Ethiopia that were conducted to assess the uptake of cervical cancer screening and its predictors, and these studies showed inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled cervical cancer screening utilization and its predictors among eligible women in Ethiopia.
Databases like PubMed, Web of Science, SCOPUS, CINAHL, Psychinfo, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All observational studies reporting cervical cancer screening utilization and/ or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. Quality assessment criteria for prevalence studies were adapted from the Newcastle Ottawa quality assessment scale. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of studies. A random effects model of analysis was used to estimate the pooled prevalence of cervical cancer screening utilization and factors associated with it with the 95% confidence intervals (CIs). From 850 potentially relevant articles, twenty-five studies with a total of 18,067 eligible women were included in this study. The pooled national cervical cancer screening utilization was 14.79% (95% CI: 11.75, 17.83). The highest utilization of cervical cancer screening (18.59%) was observed in Southern Nations Nationalities and Peoples' region (SNNPR), and lowest was in Amhara region (13.62%). The sub-group analysis showed that the pooled cervical cancer screening was highest among HIV positive women (20.71%). This meta-analysis also showed that absence of women's formal education reduces cervical cancer screening utilization by 67% [POR = 0.33, 95% CI: 0.23, 0.46]. Women who had good knowledge towards cervical screening [POR = 3.01, 95%CI: 2.2.6, 4.00], perceived susceptibility to cervical cancer [POR = 4.9, 95% CI: 3.67, 6.54], severity to cervical cancer [POR = 6.57, 95% CI: 3.99, 10.8] and those with a history of sexually transmit |
| doi_str_mv | 10.1371/journal.pone.0259339 |
| format | Article |
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Databases like PubMed, Web of Science, SCOPUS, CINAHL, Psychinfo, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All observational studies reporting cervical cancer screening utilization and/ or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. Quality assessment criteria for prevalence studies were adapted from the Newcastle Ottawa quality assessment scale. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of studies. A random effects model of analysis was used to estimate the pooled prevalence of cervical cancer screening utilization and factors associated with it with the 95% confidence intervals (CIs). From 850 potentially relevant articles, twenty-five studies with a total of 18,067 eligible women were included in this study. The pooled national cervical cancer screening utilization was 14.79% (95% CI: 11.75, 17.83). The highest utilization of cervical cancer screening (18.59%) was observed in Southern Nations Nationalities and Peoples' region (SNNPR), and lowest was in Amhara region (13.62%). The sub-group analysis showed that the pooled cervical cancer screening was highest among HIV positive women (20.71%). This meta-analysis also showed that absence of women's formal education reduces cervical cancer screening utilization by 67% [POR = 0.33, 95% CI: 0.23, 0.46]. Women who had good knowledge towards cervical screening [POR = 3.01, 95%CI: 2.2.6, 4.00], perceived susceptibility to cervical cancer [POR = 4.9, 95% CI: 3.67, 6.54], severity to cervical cancer [POR = 6.57, 95% CI: 3.99, 10.8] and those with a history of sexually transmitted infections (STIs) [POR = 5.39, 95% CI: 1.41, 20.58] were more likely to utilize cervical cancer screening. Additionally, the major barriers of cervical cancer screening utilization were considering oneself as healthy (48.97%) and lack of information on cervical cancer screening (34.34%).
This meta-analysis found that the percentage of cervical cancer screening among eligible women was much lower than the WHO recommendations. Only one in every seven women utilized cervical cancer screening in Ethiopia. There were significant variations in the cervical cancer screening based on geographical regions and characteristics of women. Educational status, knowledge towards cervical cancer screening, perceived susceptibility and severity to cervical cancer and history of STIs significantly increased the uptake of screening practice. Therefore, women empowerment, improving knowledge towards cervical cancer screening, enhancing perceived susceptibility and severity to cancer and identifying previous history of women are essential strategies to improve cervical cancer screening practice.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0259339</identifier><identifier>PMID: 34735507</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Access to information ; Cancer ; Cancer screening ; Cervical cancer ; Cervix ; Confidence intervals ; Diagnosis ; Disease susceptibility ; Early Detection of Cancer ; Educational Status ; Empowerment ; Ethiopia - epidemiology ; Evaluation ; Female ; Health sciences ; Heterogeneity ; HIV ; Human immunodeficiency virus ; Human papillomavirus ; Humans ; Immune system ; Infections ; Maternal mortality ; Medical screening ; Medicine and Health Sciences ; Meta-analysis ; Midwifery ; Morbidity ; Mortality ; Patient Acceptance of Health Care - statistics & numerical data ; People and Places ; Physical Sciences ; Prevalence ; Quality assessment ; Quality control ; Research and Analysis Methods ; Search engines ; Sexually transmitted diseases ; Statistical analysis ; Statistical tests ; STD ; Systematic review ; Uterine Cervical Neoplasms - diagnosis ; Utilization ; Utilization Review ; Womens health</subject><ispartof>PloS one, 2021-11, Vol.16 (11), p.e0259339-e0259339</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Desta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Desta et al 2021 Desta et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-b46e88dc69dac94ede10a5122de24a780301fc4bc5e44793b22e776eb6b4f2d03</citedby><cites>FETCH-LOGICAL-c692t-b46e88dc69dac94ede10a5122de24a780301fc4bc5e44793b22e776eb6b4f2d03</cites><orcidid>0000-0002-4955-2346 ; 0000-0003-3323-8202</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568159/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568159/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34735507$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Desta, Melaku</creatorcontrib><creatorcontrib>Getaneh, Temesgen</creatorcontrib><creatorcontrib>Yeserah, Bewuket</creatorcontrib><creatorcontrib>Worku, Yichalem</creatorcontrib><creatorcontrib>Eshete, Tewodros</creatorcontrib><creatorcontrib>Birhanu, Molla Yigzaw</creatorcontrib><creatorcontrib>Kassa, Getachew Mullu</creatorcontrib><creatorcontrib>Adane, Fentahun</creatorcontrib><creatorcontrib>Yeshitila, Yordanos Gizachew</creatorcontrib><title>Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening service has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. Despite this, there are limited studies in Ethiopia that were conducted to assess the uptake of cervical cancer screening and its predictors, and these studies showed inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled cervical cancer screening utilization and its predictors among eligible women in Ethiopia.
Databases like PubMed, Web of Science, SCOPUS, CINAHL, Psychinfo, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All observational studies reporting cervical cancer screening utilization and/ or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. Quality assessment criteria for prevalence studies were adapted from the Newcastle Ottawa quality assessment scale. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of studies. A random effects model of analysis was used to estimate the pooled prevalence of cervical cancer screening utilization and factors associated with it with the 95% confidence intervals (CIs). From 850 potentially relevant articles, twenty-five studies with a total of 18,067 eligible women were included in this study. The pooled national cervical cancer screening utilization was 14.79% (95% CI: 11.75, 17.83). The highest utilization of cervical cancer screening (18.59%) was observed in Southern Nations Nationalities and Peoples' region (SNNPR), and lowest was in Amhara region (13.62%). The sub-group analysis showed that the pooled cervical cancer screening was highest among HIV positive women (20.71%). This meta-analysis also showed that absence of women's formal education reduces cervical cancer screening utilization by 67% [POR = 0.33, 95% CI: 0.23, 0.46]. Women who had good knowledge towards cervical screening [POR = 3.01, 95%CI: 2.2.6, 4.00], perceived susceptibility to cervical cancer [POR = 4.9, 95% CI: 3.67, 6.54], severity to cervical cancer [POR = 6.57, 95% CI: 3.99, 10.8] and those with a history of sexually transmitted infections (STIs) [POR = 5.39, 95% CI: 1.41, 20.58] were more likely to utilize cervical cancer screening. Additionally, the major barriers of cervical cancer screening utilization were considering oneself as healthy (48.97%) and lack of information on cervical cancer screening (34.34%).
This meta-analysis found that the percentage of cervical cancer screening among eligible women was much lower than the WHO recommendations. Only one in every seven women utilized cervical cancer screening in Ethiopia. There were significant variations in the cervical cancer screening based on geographical regions and characteristics of women. Educational status, knowledge towards cervical cancer screening, perceived susceptibility and severity to cervical cancer and history of STIs significantly increased the uptake of screening practice. Therefore, women empowerment, improving knowledge towards cervical cancer screening, enhancing perceived susceptibility and severity to cancer and identifying previous history of women are essential strategies to improve cervical cancer screening practice.</description><subject>Access to information</subject><subject>Cancer</subject><subject>Cancer screening</subject><subject>Cervical cancer</subject><subject>Cervix</subject><subject>Confidence intervals</subject><subject>Diagnosis</subject><subject>Disease susceptibility</subject><subject>Early Detection of Cancer</subject><subject>Educational Status</subject><subject>Empowerment</subject><subject>Ethiopia - epidemiology</subject><subject>Evaluation</subject><subject>Female</subject><subject>Health sciences</subject><subject>Heterogeneity</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Human papillomavirus</subject><subject>Humans</subject><subject>Immune system</subject><subject>Infections</subject><subject>Maternal mortality</subject><subject>Medical screening</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Midwifery</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>People and Places</subject><subject>Physical Sciences</subject><subject>Prevalence</subject><subject>Quality assessment</subject><subject>Quality control</subject><subject>Research and Analysis Methods</subject><subject>Search engines</subject><subject>Sexually transmitted diseases</subject><subject>Statistical analysis</subject><subject>Statistical tests</subject><subject>STD</subject><subject>Systematic review</subject><subject>Uterine Cervical Neoplasms - diagnosis</subject><subject>Utilization</subject><subject>Utilization Review</subject><subject>Womens health</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk02P0zAQhiMEYpfCP0AQCQnBocVxnC8OSFW1QKWVVuLrak2cSeqVYxc76VLEj8dps6sG7QHlkMR-5p2Z154geB6RRRRn0btr01sNarE1GheEJkUcFw-C86iI6TylJH548n0WPHHumpAkztP0cXAWsyxOEpKdB39WaHdSgAoFaIE2dMIiaqmbsO-kkr-hk0aHoKtwa7GSojPWhdAaD6CSjSwVhjemRR1KHV50G2m2Et6Hy9DtXYetDxehxZ3Em4NIix3Mwde9d9I9DR7VoBw-G9-z4PvHi2-rz_PLq0_r1fJyLtKCdvOSpZjnlf-pQBQMK4wIJBGlFVIGWU5iEtWClSJBxrIiLinFLEuxTEtW04rEs-DlUXerjOOjcY4PniV5zshArI9EZeCab61swe65AckPC8Y2HKxvRSFnUVlWwpuHDFhCqiLDtCgSjARQoBnzWh_GbH3ZYiVQdxbURHS6o-WGN2bH8yTNI1_TLHgzCljzs0fX8VY6gUqBRtMf6ma08P3nHn31D3p_dyPVgG9A6tr4vGIQ5UufkuY5SYa6F_dQ_qmwlcLfslr69UnA20mAZzr81TXQO8fXX7_8P3v1Y8q-PmE3CKrbOKP64Sa6KciOoLDGOYv1nckR4cOQ3LrBhyHh45D4sBenB3QXdDsV8V-pSA5M</recordid><startdate>20211104</startdate><enddate>20211104</enddate><creator>Desta, Melaku</creator><creator>Getaneh, Temesgen</creator><creator>Yeserah, Bewuket</creator><creator>Worku, Yichalem</creator><creator>Eshete, Tewodros</creator><creator>Birhanu, Molla Yigzaw</creator><creator>Kassa, Getachew Mullu</creator><creator>Adane, Fentahun</creator><creator>Yeshitila, Yordanos Gizachew</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-4955-2346</orcidid><orcidid>https://orcid.org/0000-0003-3323-8202</orcidid></search><sort><creationdate>20211104</creationdate><title>Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis</title><author>Desta, Melaku ; Getaneh, Temesgen ; Yeserah, Bewuket ; Worku, Yichalem ; Eshete, Tewodros ; Birhanu, Molla Yigzaw ; Kassa, Getachew Mullu ; Adane, Fentahun ; Yeshitila, Yordanos Gizachew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-b46e88dc69dac94ede10a5122de24a780301fc4bc5e44793b22e776eb6b4f2d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Access to information</topic><topic>Cancer</topic><topic>Cancer screening</topic><topic>Cervical cancer</topic><topic>Cervix</topic><topic>Confidence intervals</topic><topic>Diagnosis</topic><topic>Disease susceptibility</topic><topic>Early Detection of Cancer</topic><topic>Educational Status</topic><topic>Empowerment</topic><topic>Ethiopia - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Desta, Melaku</au><au>Getaneh, Temesgen</au><au>Yeserah, Bewuket</au><au>Worku, Yichalem</au><au>Eshete, Tewodros</au><au>Birhanu, Molla Yigzaw</au><au>Kassa, Getachew Mullu</au><au>Adane, Fentahun</au><au>Yeshitila, Yordanos Gizachew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-11-04</date><risdate>2021</risdate><volume>16</volume><issue>11</issue><spage>e0259339</spage><epage>e0259339</epage><pages>e0259339-e0259339</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening service has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. Despite this, there are limited studies in Ethiopia that were conducted to assess the uptake of cervical cancer screening and its predictors, and these studies showed inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled cervical cancer screening utilization and its predictors among eligible women in Ethiopia.
Databases like PubMed, Web of Science, SCOPUS, CINAHL, Psychinfo, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All observational studies reporting cervical cancer screening utilization and/ or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. Quality assessment criteria for prevalence studies were adapted from the Newcastle Ottawa quality assessment scale. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of studies. A random effects model of analysis was used to estimate the pooled prevalence of cervical cancer screening utilization and factors associated with it with the 95% confidence intervals (CIs). From 850 potentially relevant articles, twenty-five studies with a total of 18,067 eligible women were included in this study. The pooled national cervical cancer screening utilization was 14.79% (95% CI: 11.75, 17.83). The highest utilization of cervical cancer screening (18.59%) was observed in Southern Nations Nationalities and Peoples' region (SNNPR), and lowest was in Amhara region (13.62%). The sub-group analysis showed that the pooled cervical cancer screening was highest among HIV positive women (20.71%). This meta-analysis also showed that absence of women's formal education reduces cervical cancer screening utilization by 67% [POR = 0.33, 95% CI: 0.23, 0.46]. Women who had good knowledge towards cervical screening [POR = 3.01, 95%CI: 2.2.6, 4.00], perceived susceptibility to cervical cancer [POR = 4.9, 95% CI: 3.67, 6.54], severity to cervical cancer [POR = 6.57, 95% CI: 3.99, 10.8] and those with a history of sexually transmitted infections (STIs) [POR = 5.39, 95% CI: 1.41, 20.58] were more likely to utilize cervical cancer screening. Additionally, the major barriers of cervical cancer screening utilization were considering oneself as healthy (48.97%) and lack of information on cervical cancer screening (34.34%).
This meta-analysis found that the percentage of cervical cancer screening among eligible women was much lower than the WHO recommendations. Only one in every seven women utilized cervical cancer screening in Ethiopia. There were significant variations in the cervical cancer screening based on geographical regions and characteristics of women. Educational status, knowledge towards cervical cancer screening, perceived susceptibility and severity to cervical cancer and history of STIs significantly increased the uptake of screening practice. Therefore, women empowerment, improving knowledge towards cervical cancer screening, enhancing perceived susceptibility and severity to cancer and identifying previous history of women are essential strategies to improve cervical cancer screening practice.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34735507</pmid><doi>10.1371/journal.pone.0259339</doi><tpages>e0259339</tpages><orcidid>https://orcid.org/0000-0002-4955-2346</orcidid><orcidid>https://orcid.org/0000-0003-3323-8202</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-11, Vol.16 (11), p.e0259339-e0259339 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2593588400 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Access to information Cancer Cancer screening Cervical cancer Cervix Confidence intervals Diagnosis Disease susceptibility Early Detection of Cancer Educational Status Empowerment Ethiopia - epidemiology Evaluation Female Health sciences Heterogeneity HIV Human immunodeficiency virus Human papillomavirus Humans Immune system Infections Maternal mortality Medical screening Medicine and Health Sciences Meta-analysis Midwifery Morbidity Mortality Patient Acceptance of Health Care - statistics & numerical data People and Places Physical Sciences Prevalence Quality assessment Quality control Research and Analysis Methods Search engines Sexually transmitted diseases Statistical analysis Statistical tests STD Systematic review Uterine Cervical Neoplasms - diagnosis Utilization Utilization Review Womens health |
| title | Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis |
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