COMPARATIVE ANALYSIS OF THE IMPACT OF THE WORK OF MEDICAL PERSONNEL IN URBAN AND RURAL AREAS ON THE ADHERENCE OF THE FEMALE POPULATION TO CERVICAL CANCER SCREENING

Abstract

Background. Globally, cervical cancer (CC) ranks among the most prevalent malignancies impacting women's reproductive health. Active screening significantly mitigates the incidence of invasive cervical cancer. However, the efficacy of screening programs relies on achieving a participation rate of 70% or more within the relevant age groups. This necessitates optimal population adherence to screening, a metric currently standing at 48-50% for cervical cancer screening in Kazakhstan. Literature reviews underscore various effective approaches to enhance population coverage and adherence, such as the training and involvement of healthcare personnel in screening organization. The World Health Organization attests that the success of CC screening programs hinges on the availability of an adequate number of medical personnel proficient in conducting screening tests, as well as executing subsequent diagnosis, treatment, and follow-up. Consequently, the influence of medical personnel on women's adherence to CC screening directly impacts the effectiveness of screening programs. While several studies have delved into the challenges of implementing cervical cancer screening programs in the Republic of Kazakhstan, the specific impact of medical personnel's work on the adherence of urban and rural women to cervical cancer screening remains insufficiently explored. The aim of the study. This research aims to investigate the influence of medical personnel's work on adherence to cervical cancer screening in urban and rural women. Materials and Methods. Employing a cross-sectional method, the study enrolled 384 medical workers from rural and urban primary care institutions in the Republic of Kazakhstan. Participants were categorized into two main groups based on the geographic location of the healthcare facility (city or rural). Descriptive analysis was used. Comparisons between the groups were carried out using Pearson's Chi-squared criterion, the strength of the bond was determined by Kramer's criterion V. To determine the statistical significance, the critical level of α-error was assumed to be 5%. Results: The work experience of the participants: among rural medical staff - 17.17 years, among urban ones - 14.3 years. Respondents from rural medical institutions were less likely to recommend that patients undergo CC screening; a relationship of medium strength was identified (V=0.2). In rural institutions, the main reason was limited time to see patients (23.6%). City medical workers most often answered: “This does not apply to my functions; another department is involved in screening” (33.8%). There were statistically significant differences ( χ2=12.41, p<0.05). Conclusion: The study results highlight that not all hospital staff advocate for CC screening during appointments. Notably, employees of rural medical organizations demonstrate a lower likelihood of recommending screening, potentially contributing to the limited awareness and commitment of rural women to CC screening.