Date of Award

Summer 8-11-2011

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Richard Rothenberg

Second Advisor

Ike Okosun

Abstract

This study assesses the vulnerability of Haitian women to cervical cancer by looking at the distribution of socio-demographic factors that might prevent their access to health services. Predictor variables of access to health services and variables known to be directly associated to an increased risk for cervical cancer were derived from the Haitian Demographic Health Survey (2005-2006). Five socio demographic predictors of access to health services were considered: Education, wealth index, distance to health services, type of place of residence and whether or not money was a problem to get medical help. The dependent variable used to categorize women into low risk group and high risk group to cervical cancer was created from three variables: young age at first sexual intercourse, more than two sexual partners and can the woman ask her partners to use condom. To study the association between the socio-demographic and economic predictors to access to health services and high risk group of women to cervical cancer, binary logistic regression was conducted. The univariate analysis performed showed that women who were in the high risk group to cervical cancer were more likely to be uneducated (OR= 2.447; p-value<0.0001), poor (OR=2.372; p-value<0.0001), to have economic barriers that prevent their access to health services (OR=1.566; p-value<0.05) and were more likely to live in rural areas (OR=1.705; p-value<0.0001). However, after running the multivariate analysis to control for the other predictors, only level of education (OR= 1.991; p-value<0.0001) and wealth status (OR=1.727; p-value<0.05) were still associated to the dependent variable. These findings proved that interventions that aimed at controlling cervical cancer among Haitian women should take into consideration these indirect socio-demographic and most important economic factors that might prevent the high risk group of women to benefit from the appropriate screening and treatment services, provided that they are available. Finally recommendations to find a better approach to address the cervical cancer burden in Haiti are made.

INDEX WORDS: Uterine cervical neoplasmas, risk factors, accessibility to health services, developing countries

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