Investigating the Healthcare-Seeking Behaviors of Mobile Phone Users to Improve Cervical Cancer Screening in Rural Uganda

PURPOSE Cervical cancer is the leading cause of cancer in low- and middle-income countries, despite being a preventable disease. Uganda, which lacks an effective screening program, has one of the highest cervical cancer incidence rates in the world. However, mobile health (mHealth) technology has the potential to improve healthcare-seeking behaviors and access to cervical cancer screening. This study aims to describe the connection between mobile phone access and healthcare-seeking behaviors in rural Uganda. METHODS This cross-sectional study recruited participants from January 23 to August 24, 2023. Women were eligible if they had no prior screening or treatment for cervical cancer in the past 5 years, were aged 30 to 49 years old, and were residents of the South Busoga Forest reserve. Each participant completed a 43-item survey which included questions on demographics, previous health service usage, and opinions on cervical cancer prevention. Bivariate data was analyzed using descriptive statistics and chi-square tests. RESULTS Of the 1434 participants included in the analysis, 91.4% (n = 1310) reported having access to a mobile phone. The majority of participants were aged 30-40 years (n = 929, 64.8%), reported being married or in a relationship (access, n = 1133, 86.5% no access, n = 106, 85.5% p= 0.948), had ≤ primary education (access, n = 1157, 88.3% no access, n = 114, 91.9% p=0.434), and reported farming as their occupation (access, n = 1114, 85.0% no access, n = 101, 81.5% p=0.438). 1143 (87.3%) of individuals in the access group and 90 (72.6%) of those in the no access group reported ever attending a healthcare outreach visit (p<0.001). Additionally, 96.9% (n = 1269) of the access group and 93.5% (n = 116) of the no access group reported that they had ever visited a health center (p<0.001). CONCLUSION While attendance to healthcare outreach visits or health centers was high amongst participants, those with mobile phone access were more likely to seek healthcare services. Further inquiry into this association between mobile phone access and healthcare-seeking behavior is needed to optimize the improvements to cervical cancer screening when implementing interventions such as mHealth technology.