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Research Article | DOI: https://doi.org/10.31579/2640-1053/236
Department of Nursing Science, Faculty of Health Sciences, Imo State University (IMSU) Owerri, Imo State, Nigeria.
*Corresponding Author: Uloneme Chinwe Elizabeth, Department of Nursing Science, Faculty of Health Sciences, Imo State University (IMSU) Owerri, Imo State, Nigeria.
Citation: Uloneme Ch. E., Emesowum A. Chinwendu and N. S. Adanma (2025), Awareness, Attitude and Acceptance of Cervical Cancer Screening Among Mothers in Selected Communities in Obowo and Owerri North L.G.A. In Imo State, J. Cancer Research and Cellular Therapeutics. 9(3); DOI:10.31579/2640-1053/236
Copyright: © 2025, Uloneme Chinwe Elizabeth. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 27 March 2025 | Accepted: 07 April 2025 | Published: 14 April 2025
Keywords: awareness; attitude; cervical cancer; screening; mothers
This study ascertained the awareness, attitude and acceptance of cervical cancer screening among mothers in Obowo and Owerri North L.G.A. in Imo State. The study was carried out using a descriptive cross sectional research design, having four research questions and two hypotheses. The population of the study comprised 1240 women in Obowo and Owerri North LGAs and a sample size of 302 women were selected from the two groups of women. This size was determined using the Taro Yamane formula. The instrument used for data collection was a questionnaire sectioned in 4 parts viz A for awareness of cervical cancer; B- attitude of women towards cervical cancer screening; C- acceptance level of cervical cancer screening; and D- barriers to uptake of cervical cancer screening. The research questions were answered using mean scores while the hypotheses were tested using chi-square statistics on SPSS 24. The major findings are that fifty-seven (57.00%) and (38.40%) of the respondents in Obowo and Owerri North have good awareness of cervical cancer while 43.00% and 61.50% have poor awareness of cervical cancer and this awareness is significantly related to demographic variables; majority of the respondents in Obowo and Owerri North have positive attitude towards cervical cancer screening (2.83 and 2.58 respectively). However, women of Obowo have a higher mean attitude score than women of Owerri North; among the women who have not undergone the test, only 33.30% of the women in Obowo are willing to take up the test and only 34.20% of the women in Owerri North are willing to take up cervical cancer screening implying that both women in the LGAs have low rate of acceptance of cervical cancer screening among them and acceptance is significantly related to awareness (p<.05); among the respondents who have not taken the screening, their major barriers are fear of pain (60%), cost implications (45.40%), fear of diagnosis (36.10%), free screening (48.80%) and many more. The researcher recommends among others that every woman of childbearing age should take up cervical cancer screening.
Cervical cancer is a preventable noncommunicable disease of public health importance, and the second most common cancer in women. Worldwide, 80% of cervical cancer cases occurred in developing countries. Global trends show that, in developing countries going through rapid societal and economic changes, the shift towards lifestyles like that of industrialized countries leads to a rising burden of cancers. The incidence of cervical cancer varies greatly worldwide. There is a large difference between developing and developed countries, where cervical cancer cases have been significantly reduced since the implementation of effective screening programs. The success of any screening program will depend on proper rendering of services, health professionals, availability, low cost, and, above all, the awareness and attitude of women at the receiving end [1].
Highest incidence of cervical cancer related death occurs among middle age women about 30–40 years. Of the 273,505 deaths recorded, 80% occurred in low and middle-income countries. In Sub-Saharan Africa (SSA), of the 78,897 women diagnosed with cervical cancer annually, 61,671 deaths were recorded which makes the disease one of the most prevailing cancers. In Uganda, Mali, Nigeria, and Zimbabwe, cervical cancer is the second most prevailing cancer among women aged 15–44 years. A major misconception lies in the treatment of cervical cancer which is viewed as the removal and reinsertion of the womb and believed to cause unavoidable death. In SSA, cervical cancer is yet to be acknowledged as an important public health problem. The low awareness of the disease in Africa which cuts across different literacy levels have been reported [2]
The Ministry of Health and Child Welfare, Zimbabwe introduced the VIAC screening in 2011. In order to make cervical cancer screening affordable to the majority of women in the country, VIAC is offered for free in public hospitals [3]. Yet, despite these efforts, the uptake of cervical cancer screening in Zimbabwe is still quite low. The uptake of cervical cancer screening stands at 9.4% (all women aged 25–64 years) in the country. Of the 47,916 women aged 15–47 years in Chegutu Rural District, only 2.1% have been screened for cervical cancer through VIAC since 2014. There is low uptake of cervical cancer screening in Zimbabwe and other Southern African countries (e.g., Swaziland and Malawi), despite the fact that these countries have the highest age-standardized incidence rates globally of 62.3, 75.3 and 72.9 per 100,000, respectively [4]
Cervical cancer (CC) is the most common gynecological cancer. Ninety-nine percent of all cases are linked to infection with high-risk human papillomaviruses (HPVs) which may be transmitted through sexual contact. Cervical cancer ranks fourth among the common cancers in women worldwide; only breast, colorectal and lung cancers are more common. Of the 570,000 cases of CC diagnosed globally in 2018, there were 311,000 deaths; 85% of which were from developing countries. This makes it a major public health problem with a predisposition for middle-aged women in resource constrained countries. Most of these deaths are largely preventable with access to comprehensive cervical cancer prevention (CCP) and control programs which improve uptake of HPV vaccination among young girls, screening all at-risk women and treating pre-cancerous lesions [5].
In most developing countries especially with high HIV/AIDs prevalence and with poor screening programs, cervical cancer remains one of the commonest female cancers with about 75% or more of affected women presenting in advanced stage with poor prognosis (Attah et al., 2010). About 80% of the new cases and deaths occur in developing countries. The incidence of cervical cancer varies greatly worldwide. There is a large difference between developing and developed countries. In developed countries, cervical cancer cases have been significantly reduced since the implementation of effective screening programs. However, in developing countries, the burden from cervical cancer remains high because of the difficulty in implementing cytology-based screening programs [6].
According to the 2015 world cancer statistics, cervical cancer is the fourth most common cancer in women globally; 528000 new cases each year but the second most common in developing countries; 445000 new cases each year. cervical cancer is the fourth most common cancer in women, with an estimated 530,000 new cases every year, representing 7.9% of all female cancers. In 2015, approximately 90% of the 270,000 deaths from cervical cancer occurred in low- and middle-income countries. Mortality rate remarkably varies among different regions of the world, with rates ranging from less than 2 per 100,000 in Western Europe and New Zealand to 27.6 per 100,000 in Sub-Saharan Africa [7]
In Ethiopia, where ROCs are a widespread, but rare, acknowledged the problem. Nearly out of 22 million Ethiopian women over the age of 15 years, approximately 7,600 are diagnosed with cervical cancer, and roughly 6,000 women die of the disease yearly. Arranged screening is more cost-effective than opportunistic screening, making better use of available resources and ensuring that the greatest number of women will benefit [8]
In Nigeria, 70 327 deaths in women were attributed to cancer, with cervical cancer causing 14.8% of those deaths in 2018, making it the second most common cancer after breast cancer. A frequent occurrence in Nigeria is a trend of late presentation and diagnosis at advanced stages of the disease leading to poor prognosis. About 118 million women have been immunized against HPV, of which only 1% are from low- to middle-income countries, with numerous barriers reported [9]
Cancer of the cervix is a major burden on women's health worldwide. It is ranked as the second most frequent cancer among women aged 15 to 44. There has been a decline in cervical screenings conducted annually in Nigeria from 82,041 to 23,527 in 2015. In Nigeria, 53.3 million women are estimated to be at risk of developing cervical cancer with a national standardized prevalence rate of 33.0 per 100,000. Many factors such as sexually transmitted infections, reproductive factors, hormonal influences, genetic and host factors have been implicated in the occurrence of cervical cancer [10].
The decline in cervical screening among women could results in high morbidity and mortality from this disease with a devastating impact on society. Cervical screening ensures early detection of precursor lesions and immediate medical and surgical intervention will be carried out to prevent death. Cancer is responsible for the premature removal of many economically active women, mothers, and grandmothers from society [11]. This poses not only financial burden on a family, but also social and emotional trauma to other family members, an alteration in family structure because young children must drop out of school to become caregivers, a loss of amenities, and a fall below poverty line. Nigerians living in the rural areas are generally known to be suffering from general deprivation including access to information resources and health services. On this note, the researcher is determined and interested to explore a comparative study within the rural communities of Obowo and Owerri North L G A in Imo State in order to reveal the acceptance of cervical cancer screening among the rural women in the communities.
Research Design.
The researcher used the descriptive cross-sectional study
Area of Study/Setting
The study was conducted in Obowo Local Government Area , Imo State in this part of Nigeria Obowo, also spelled Obowu is a Local Government Area in Imo State,
Population of Study
The study of population comprises selected women in Obowo L.G.A. The target population of women was collected in the sub villages in Obowo and Owerri North Local Government Area, Imo State with the total number of 1240 women.
Inclusion Criteria: The inclusion criteria for the study population are as follows: women in Obowo North L.G.A. during the specified time frame.
Exclusion Criteria: The study excluded:
1.Women who refused to participate in the study.
2.Women who were unable to comprehend what the research entails.
| Owerri North | Women in the Village. | Obowo | Villages |
| Aboh Mbaise | 123 | Achara | 102 |
| Ehime Mbano | 114 | Amanze | 120 |
| Ezinihitte | 122 | Umuariam | 128 |
| Ideato North | 131 | Umuagu | 139 |
| Ikeduru | 130 | Avutu | 131 |
| 620 | 620 | ||
| Total | 1,240 |
Table 3.1: Showing the population of women in Owerri North and Obowo L.G.A.
Instrument for Data Collection
The instrument used for data collection in this study was a semi-structured questionnaire derived from review of available literature. All questions are closed-ended. The instrument for data collection consists of Five (5) sections.
Section A: Demographical Data
Section B: Consist of awareness of cervical cancer screening among the women of Obowo and Owerri North L.G.A, Imo State.
Section C: consist of the attitudes toward cervical cancer screening among the women of Obowo and Owerri North L.G.A., Imo State.
Section D: Consist of the level of acceptance of cervical cancer screening among the women of Obowo and Owerri North L.G.A. Imo State.
Section E: Consist of factors associated with the uptake of cervical cancer screening among women of Obowo L.G.A in Imo State.
Validity of the Instrument.
The instrument for data collection was constructed and submitted to the supervisor who did proper evaluation on the organization and relevance of each item in answering research question. The supervisor then made correction before it was approved for administration.
Reliability of instrument.
The reliability is defined as the consistency which the instrument does what it is supposed to do. In checking for the reliability of the instrument, a pre- test will be conducted among mothers which is not among those that were selected by the researcher in the sample to ascertain the reliability of the research instrument. A total of 23 questionnaires will be given to 23 respondents from Owerri North and Obowo L.G.A. for this purpose. The reason will be to determine whether the responses would be in line with the required result expected from the instrument. Then another set of same questionnaires will be re- administered to the same 23 mothers where the responses gotten will be recorded using Pearson’s Product Moment Correlation Coefficient (PPMCC) as the technique for analysis. The two cores obtained from the test and re-test procedure will also be calculated to show the reliability index.
Method of Data Collection.
The respondents are mothers. They were selected from each Local Government in Owerri North and Obowo, the distribution of the questionnaire will last for less than 21 days as the researcher intends to cover the population. A total of 1,240 questionnaires will be shared and distributed. Information to be obtained from the respondents will be used to make a good general statement about mothers in Owerri North and Obowo L.G.A. Imo State.
Statistical analysis Analysis
The simple frequency distribution and simple percentage method were adopted in the data analysis of the study. In this study, the statistical Software used to analyze the data is the Statistical package for social sciences (SPSS).
In this chapter, the results of data collected are arranged and presented
| Variable | Category | Frequency =302 | Percentage (%) |
| Age | 20-29 30-39 40-49 50-59 60 and above | 30 59 138 45 30 | 10.00 19.40 45.60 15.00 10.00 |
| Marital status | Single Married Separated Widowed
| 49 211 12 30
| 16.20 69.90 3.90 10.00
|
| Level of education | No formal education Primary education Secondary education Tertiary education | 37 49 98 118 | 12.30 16.20 32.50 39.00 |
Table 4.1: Demographic data of respondents
Data on table 4.1 show the demographic characteristics of the respondents. The data show that majority of the respondents are aged 40-49 years (45.60%). There are more married women in the sampled population (69.90%) and majority are graduates of tertiary institutions (39.00%).
| Variable | Options | Frequency Obowo = 151 | % | Frequency Owerri North= 151 | % |
| Heard of cervical cancer | Yes No | 121 30 | 80.10 19.90 | 75 76 | 49.70 50.30 |
| Source of information | Health personnel Friends/family Social media Church | 100 11 10 0 | 82.60 9.10 8.30 | 45 15 15 0 | 60.00 20.00 20.00 |
| Understanding of cervical cancer | Cancer of the cervix Cancer of the buttocks Cancer of the anus Cancer of the vagina No idea | 121 0 0 30 0 | 80.10 0 0 19.90 0 | 50 0 0 25 76 | 33.20 0 0 16.60 50.30 |
| Understanding of cervical cancer screening | Medical procedure to treat cancer Detecting abnormal cells in cervix Detecting people at risk Managing cervical cancer | 50 71 20 10 | 33.10 47.00 12.30 6.60 | 45 50 33 23 | 29.80 33.10 21.90 15.20 |
| Cervical cancer can be prevented | Yes No | 83 68 | 55.00 45.00 | 39 112 | 25.80 74.20 |
| Risk factors of cervical cancer (multiple answers) | Multiple sex partners Long use of oral contraceptives Smoking Weak immune system High risk of HPV Early sexual intercourse Multiple full term pregnancies | 121 39 97 110 121 33 19 | 80.10 25.80 64.20 72.80 80.10 21.90 12.60 | 81 33 31 98 72 19 10 | 53.60 21.90 20.50 65.00 47.70 12.60 6.60 |
| Mean awareness score | 11.40 | 7.70 | |||
| General awareness level | Good awareness Poor awareness | 86 65 | 57.00 43.00 | 58 93 | 38.40 61.50 |
Note: maximum awareness score = 20points. Good awareness =individuals scoring more ≥10 points, Poor awareness = women scoring<10>
Table 4.2: Awareness of cervical cancer screening among the women of Obowo and Owerri North L.G.A, Imo State
Data on table 4.2 show the awareness of the respondents in Obowo and Owerri North on cervical cancer. The data show that 80.10% of the women in Obowo have heard of cervical cancer, contrary to only 49.70% of women who have heard it in Owerri North.
Furthermore, 47% of the respondents in Obowo and 33.10% in Owerri North correctly pointed out that cervical cancer screening is a process to detect abnormal cells in the cervix. Also, majority of the women in Obowo are aware of the risk factors of cervical cancer while only a few women in Owerri North LGA are knowledgable about the risk factors of cervical cancer. Generally, women in Obowo have a mean awareness score of 11.40 while respondents in Owerri North have a mean awareness score of 7.70. Specifically, 57.00% and 38.40% of the respondents in Obowo and Owerri North have good awareness of cervical cancer while 43.00% and 61.50% have poor awareness of cervical cancer. Comparing both LGAs, it can be seen that respondents in Obowo have more awareness about cervical cancer than the women in Owerri North.
| Group | n | Mean | t-stat | Df | p-value |
Obowo Owerri North | 151 151 | 11.40 7.70 | 23.637 | 300 | .000* |
P is significant at p<.05
Table 4.3: Independent samples t-test of significant difference in the cervical cancer awareness of women in Obowo and Owerri North
Data on table 4.3 show the independent samples t-test of difference in the awareness of cervical cancer among women in Obowo and Owerri North LGA. The t-statistic value is high at 23.637. The p-value is given as .000 which is less than .05. The null hypothesis is rejected and it is concluded that there is a statistically significant difference between the cervical cancer awareness levels of women in Obowo and Owerri North LGAs.
| Obowo n = 151 | Owerri North n = 151 | ||||||
| S/N | ITEMS | ||||||
| 1 | Cervical cancer screening is essential | 2.80 | 0.74 | Positive | 2.74 | 0.82 | Positive |
| 2 | It is important that every woman go for Cervical Cancer Screening. | 2.81 | 0.75 | Positive | 2.99 | 0.81 | Positive |
| 3 | I will go for Cervical Cancer Screening | 2.80 | 0.74 | Positive | 2.31 | 0.77 | Negative |
| 4 | I will advice friends, my daughters to go for Cervical Cancer Screening | 3.00 | 0.89 | Positive | 2.51 | 0.21 | Positive |
| 5 | Regular cervical cancer screening is essential for maintaining good health. | 2..80 | 0.40 | Positive | 2.81 | 0.38 | Positive |
| 6 | Cervical cancer screening can detect cancer early when it is most treatable. | 3.01 | 0.63 | Positive | 2.71 | 0.89 | Positive |
| 7 | Cervical cancer screening should be a routine part of women’s healthcare. | 2.70 | 0.88 | Positive | 2.90 | 0.89 | Positive |
| 8 | Educating others about cervical cancer screening is important | 3.12 | 0.71 | Positive | 2.41 | 0.70 | Negative |
| 9 | Cervical cancer screening can save lives. | 2.60 | 0.49 | Positive | 2.22 | 0.64 | Negative |
| 10 | Cervical cancer screening is a priority in my healthcare routine. | 2.85 | 0.61 | Positive | 2.57 | 0.66 | Positive |
| 11 | I am satisfied with the information I receive about cervical cancer screening form my healthcare provider. | 2.67 | 0.11 | Positive | 2.31 | 0.81 | Negative |
| Cumulative mean | 2.83 | 2.58 | |||||
Table 4.4: Attitudes toward cervical cancer screening among the women of Obowo and Owerri North L.G.A., Imo State
Data on table 4.4 show the attitudes of women in Obowo and Owerri North towards cervical cancer screening. The data show that all the items in the rating scale on the part of Obowo women are all above 2.50 with a cumulative mean of 2.83, implying that majority of the women in Obowo have positive attitude towards cervical cancer screening. Meanwhile, the cumulative mean score for attitude of Owerri North women towards cervical cancer screening is 2.58also indicating positive attitude among majority of the respondents towards cervical cancer screening. However, the mean of the women in Obowo is higher than the cumulative mean for Owerri North women, implying that women in Obowo have more positive attitudes towards cervical cancer screening compared to their counterparts in Owerri North.
| Group | n | mean | t-stat | df | p-value |
Obowo Owerri North | 151 151 | 2.83 2.58 | 21.752 | 300 | .000* |
P is significant at p<.05
Table 4.5: Independent samples t-test of significant difference in the cervical cancer screening attitude between women in Obowo and Owerri North
Data on table 4.5 show the independent samples t-test of difference between the attitude of women in Obowo and Owerri North LGA towards cervical cancer screening. The t-statistic value is given as 21.752. The p-value is given as .000 which is less than .05. The null hypothesis is rejected and it is concluded that there is a statistically significant difference between the attitude of women in Obowo and Owerri North LGAs towards cervical cancer screening.
| Variable | Options | Frequency Obowo= 151 | % | Frequency Owerri North= 151 | % |
| Undergone cervical cancer screening | Yes No | 61 90 | 40.40 59.60 | 37 114 | 24.50 74.50 |
| If yes, what type of screening did you undergo? |
| 32 29 0 | 52.50 47.50 0 | 37 0 0 | 100.00 |
| Will you like to undergo cervical cancer screening (among those who have not gone) | Yes No | 30 60 | 33.30 66.70 | 39 75 | 34.20 65.80 |
Table 4.6: level of acceptance of cervical cancer screening among the women of Obowo and Owerri North L.G.A. Imo State
Data on table 4.6 show the acceptance level of cervical cancer screening among women in Obowo and Owerri North LGAs. The findings show that 40.40% of the women in Obowo have undergone cervical cancer screening while only 24.50% of the women in Owerri North have undergone cervical cancer screening. Pap smear is the most popular type of screening undergone by women in both local government areas for cervical cancer screening. Among those who have not undergone the test, only 33.30% of the women in Obowo are willing to take up the test and only 34.20% of the women in Owerri North are willing to take up cervical cancer screening implying that both women in the LGAs have low rate of acceptance of cervical cancer screening among them.
| Variable | Acceptance | Total (%) | df | X2 | p- value | |
| High = | Low = | |||||
Group of women Obowo Owerri North |
30 39 |
60 75 |
90 114 |
1 |
.017 |
.895 |
| Total |
P is significant at p<.05
Table 4.7: Chi-square summary table for differencebetween acceptance of cervical cancer screening among women in Obowo and Owerri North LGAs
Data on table 4.7 show the chi-square summary for the difference in the cervical cancer screening acceptance levels of women in Obowo and Owerri North LGA. The p-value is given as .895 which is greater than the .05 significance level. The null hypothesis is therefore not rejected and it is concluded that there is no statistically significant difference between the cervical cancer screening acceptance levels of women in Obowo and Owerri North LGAs.
| Variable | Options | Frequency =302 | % |
| Been screened | Yes No | 97
205 | 32.10
67.90 |
| Barriers to uptake of cervical cancer screening (among those without uptake) | Lack of free screening | 100 | 48.80 |
| Recommendation from health care provider | 31 | 10.30 | |
| Awareness campaign | 52 | 17.20 | |
| Fear of pain | 181 | 60.00 | |
| Fear of diagnosis | 109 | 36.10 | |
| Cost implications | 137 | 45.40 |
Table 4.8: factors associated with the uptake of cervical cancer screening among women of Obowo and Owerri North L.G.A in Imo State
Data on table 4.8 show the factors associated with uptake of cervical cancer screening among women of Obowo and Owerri North. Among the respondents who have not taken the screening, their major barriers are fear of pain (60%), cost implications (45.40%), fear of diagnosis (36.10%), lack of free screening (48.80%) and many more.
| Variables | Beta | Exp(B)/Odds ratio | p-value |
| Free screening | .119 | .992 | .066 |
| Recommendation from health care provider | .128 | .718 | .071 |
| Awareness campaign | .887 | .910 | .221 |
| Fear of pain | .311 | 2.113 | .010 |
| Fear of diagnosis | 1.095 | 3.590 | .002 |
| Cost implications | 1.003 | 4.001 | .011 |
Table 4.9: Logistic regression summary table for relationship between uptake of cervical cancer and associated factors
Data on table 4.9 show the logistic regression summary of relationship between uptake of cervical cancer screening and the factors associated with cervical cancer uptake. The odds ratio (ExpB) from the logistic regression show that free screening is associated with cervical cancer screening uptake by .992 times (p>.05), recommendation from healthcare provider is associated to uptake by .718 (p>.05); awareness campaigns are associated with uptake by .910 times (p>.05); fear of pain increases screening uptake by 2.113 times (p<.05); fear of diagnosis (OR: 3.590, p<.05) and cost (OR: 4.001, p<.05). The p-values show that only fear of pain, diagnosis and cost implications are significantly associated with cervical cancer screening uptake.
Findings from research question 1 revealed that fifty-seven (57.00%) and (38.40%) of the respondents in Obowo and Owerri North have good awareness of cervical cancer while 43.00% and 61.50% have poor awareness of cervical cancer respectively. Comparing both LGAs, it can be seen that respondents in Obowo are more knowledgeable about cervical cancer than the women in Owerri North. This generally means that a good number of respondents have good awareness of cervical cancer although not much among Owerri North women. The hypothesis supporting the question reveal a significant difference in the cervical cancer awareness levels of the women in Obowo and Owerri North LGA (p<.05). The reason for this finding could be directly linked to the fact that Obowo LGA are currently recipients of varieties of cervical cancer awareness programmes run by various NGOs.
This finding on high awareness among women in Obowo is in line with the findings of [12] on the determinants of awareness of cervical cancer, attitude towards screening and practice of cervical cancer prevention in which a record of high awareness of cervical cancer among 60.60% of the women sampled for the study. Also supporting the findings on Awareness and acceptability of cervical cancer screening among female undergraduates where they reported good awareness of cervical cancer among 68.4% of their respondents [13,14]. The findings however, debunk the researcher’s findings on the awareness level of women of Owerri North on cervical cancer which is relatively lower.
It is seen that majority of the respondents in Obowo and Owerri North have positive attitude towards cervical cancer screening (2.83 and 2.58 respectively). However, women of Obowo have a higher mean attitude score than women of Owerri North. The reason for the finding may not be farfetched given the fact that more light is being shed on the dangers of cervical cancer and the need to find all means to protect oneself from the condition. The corresponding hypothesis show a significant difference in the attitude of women in both local government areas towards cervical cancer screening (p<.05).
This finding is strongly supported by the findings of [15] who conducted a study on attitude and perceived barriers among women towards cervical cancer screening and discovered that majority of the women do possess a favorable attitude towards cervical cancer screening. However, a major gap is still a hindrance between women’s perception and practice.
Also in line with the findings above are the findings of [16] on Awareness and attitude towards cervical cancer among reproductive age group women in Gondar town in which a high record of favour favourable attitude towards cervical cancer screening was recorded among the women sampled for the study.
Results from the findings on research question 3 show that among those who have not undergone the cervical cancer test, only 33.30% of the women in Obowo are willing to take up the test and only 34.20% of the women in Owerri North are willing to take up cervical cancer screening implying that both women in the LGAs have low rate of acceptance of cervical cancer screening among them. There is also no statistically significant difference in the cervical cancer screening acceptance levels of women in Obowo and Owerri North LGAs (p>.05). This implies that the acceptance level of cervical cancer screening is similar among the women in both Obowoand Owerri North LGA.
In line with this finding are the findings of [17] on awareness and acceptance of cervical cancer screening among women in Ethiopia where most of the women sampled had poor awareness and acceptance of cervical cancer screening. In the same vein, it recorded poor acceptance of cervical cancer screening among their respondents in Ethiopia.
The findings from research question 4 revealed that among the respondents who have not taken the screening, their major barriers are fear of pain (60%), cost implications (45.40%), fear of diagnosis (36.10%), free screening (48.80%) and many more. This coincides with the findings of [18] on Barriers to the Uptake of Cervical Cancer Screening and Treatment among Rural Women in Ghana. They found out from their study that cost of screening, fear of diagnosis and pain were major barriers to uptake of cervical cancer screening. The corresponding hypothesis show that only fear of pain, diagnosis and cost implications are significantly associated with cervical cancer screening uptake (p<.05) respectively.
Also supporting the findings above are those of [19] who discovered that perceived barriers predicted uptake of cervical cancer screening (P< 0 xss=removed xss=removed CI=0.679, xss=removed xss=removed xss=removed>
Cancer of the cervix has been established as a major burden on women's health worldwide. It is ranked by WHO as the second most frequent cancer among women aged.Overtime, there has been a decline in cervical screenings conducted annually in Nigeria. Many factors such as sexually transmitted infections, reproductive factors, hormonal influences, genetic and host factors have been implicated in the occurrence of cervical cancer.The decline in cervical screening among women could result in high morbidity and mortality from this disease with a devastating impact on society. Cervical screening ensures early detection of precursor lesions and immediate medical and surgical intervention will be carried out to prevent death. The findings of this study glaringly revealed the cervical cancer awareness and screening uptake gaps among women in Obowo and Owerri North LGAs of Imo State. This becomes a call for health professionals to increase their awareness campaigns on cervical cancer and cervical cancer screening so as to save numerous lives from the problem of cervical cancer.
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Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
