1. Chapter 1
1.1. Background of the study
Cancer has emerged to be the 3rd leading killer disease in Kenya after infectious and cardiovascular diseases. Cervical cancer ranks amongst the most frequent cancer among Kenyan women. According to (HPV (Human Papillomavirus) Information Centre, 2018), each year more than 5000 Kenyan women are diagnosed with cervical cancer while more than 3000 die from the disease. Women between the age of 15 to 44 years often become at a risk of contracting cervical cancer, which is about 14.3 million people of the Kenyan population.
Cervical cancer has been most common in developing countries due to increased poverty levels and lack of information. Developed countries have enjoyed little ‘immunity’ over the disease due to extensive resources to aid early detection and prevention. (Rhoydah Mogoi, 2016) Nearly 75% of women in Africa who develop cervical cancer are in the rural settlements. These women often go untreated due to lack of finances and access to medical facilities for screening, and lack of awareness on the symptoms and prevention of the disease.
Information is a key tool in all facets of human existence. The mass media have played a crucial part in mobilization in the fight against diseases that have previously caused unrest among people such as HIV and Malaria. One of the most important controls of cervical cancer is attending regular checks to aid early detection. However, many Kenyan women have little information, hence realize the disease when it is almost late. Cancer has over the past been linked to misconceptions with those having little or no knowledge; some believing it is witchcraft. This lack of relevant information has contributed to ignorance and reluctance by women to visit health centers to ascertain health conditions. Some experience fear that cervical cancer is a disease that would make a woman’s life difficult.
Medical practitioners have also failed in providing relevant information to ease control of the disease (A. Nattembo, 2018). Most women have not realized the ‘real’ causes of cervical cancer. Mass media such as newspapers, social media, TV, and radio stations have been reluctant in delivering relevant information to people. The mass media should play an important role in creating awareness of cervical cancer screening, causes, and risk minimization practices.
1.2. Problem statement
Cervical cancer has contributed to the rise in mortality rate among women in Kenya and globally, yet it is preventable and curable. With poverty rates skyrocketing, victims have fallen into the risk of demise from the malignancy. Most of the women have little or no knowledge of the importance of regular cancer screening. Unfortunately, only about 16% of the Kenyan women populace attend regular cervical cancer screening.
Lack of relevant information among other factors has contributed to the low turnouts of women in the malignancy screening programs. Mass media has been putting minimal effort in “preaching” about cervical cancer; its symptoms, preventive measures, and cure before it goes through stages 3 and 4.
1.3.1. General Objectives
- To help understand the role of mass media in creating awareness of cervical cancer in a bid to minimize mortality rates in Kenya.
1.3.2. Specific Objectives
- To help understand preventive and curative measures to adopt to control cervical cancer by Kenyan women.
- To realize factors that inhibit access of relevant information about cervical cancer and regular screening programs in Kenya.
- To understand influence of print and audiovisual media in facilitating knowledge about cervical cancer by Kenyan women.
1.4. Research questions
The research was guided by the following questions with compliance to the research objectives:
- What are the relevant channels of communication that can be incorporated to ensure information about cervical cancer and screening programs is received by the Kenyan women?
- How informed are Kenyan women who are at risk of developing cervical cancer?
- What is the influence of electronic media in providing information about cervical cancer to Kenyan women?
- What are the key issues that undermine access to relevant information about cervical cancer by Kenyan women seeking reproductive services?
1.5. Significance of the research
Over the past years, cervical cancer has brought some worrisome trends. At least 5250 new cases of cervical cancer are realized in Kenya each year (HPV Information Centre, 2018). According to statistics performed by HPV Information Centre, annually, more than 3000 deaths are experienced due to cervical cancer in Kenya.
The research was conducted to analyze the influence that mass media impacts on its audience as a way of providing a solution to the epidemic. With the large audience enjoyed by the audiovisual and print media, they have an obligation to turn things round. So far very little effort has been put by the mass media in establishing educational campaigns against cervical cancer morbidity. Media corporations were targeted by the researcher as they have control over what information is shared on their platforms.
The research was relevant in that the results would help medical institutions and practitioners in understanding better methods of passing out health information to the mass. It would help government agencies understand the weight and collective impact of the epidemic to the state’s economy.
1.6. Scope of the research
The study was conducted in Embakasi Central, Nairobi county. The researcher obtained data from 21 women aged between 15-45 years. The main aim was to analyze the role played by mass media in sensitization of Kenyan women about cervical cancer. The researcher incorporated two theories; limited-effects and class-dominant theory. The class dominant theory shows the control of mass media by corporations and their influence on the type of information aired in stations. The limited-effects theory shows the power of the media to influence decisions of the less informed.
The study focused on various factors that hindered access to information and how Kenyan women perceive importance of knowledge of health information. The research questions aimed at understanding the most appropriate channels of communication that Kenyan women preferred. This was to help the medics on how best to relay information to the users.
1.7. Limitations and delimitations of the study
The research was accompanied by several setbacks, i.e. the data collection process took longer than was expected to due to legal frameworks that were to be followed. Obtaining a permit letter from the area chief to conduct the study took 3 days which was much time in relation to the research time frame. However, the researcher managed to abide by the regulations.
Data collection from the target populace was so tiring as most were unwilling to offer information. Some women would ask for a “little tip” in order to fill in the questionnaires. The whole data collection process was gruesome and required patience for the researcher to get relevant and adequate information. The process was always in suspense whenever respondents felt to perform their personal duties. Therefore, the researcher hustled to get most of the data within the shortest time available.
2. Chapter 2
2.1. Literature review
The chapter reviews the literature about the relevance of mass media as a tool used in sensitization of women about cervical cancer; its symptoms, effects, and preventive mechanisms.
Mass media is a type of communication level that reaches a large audience whether in written, oral, or broadcast form. Forms of mass communication include television, radio, newspapers, magazines, the Internet, billboards, posters, and so many others. Mass media plays a great role in connecting multitudes in different geographical situations by sharing common networks.
The literature identified two important theories that would shed light on role of the mass media in the minimization of cervical cancer morbidity: limited-effects theory and class dominant theory.
According to Paul Lazarsfeld’s limited-effects theory of media effects, the media rarely influences decisions made by individuals. However, the propaganda spread directly affects socially isolated –those with little access to information.
Advocates of class dominant theory argued that media is controlled by a few elites who then determine what information is shared. Therefore, it implied that the few elites could help create awareness of cervical cancer.
2.1.2. Causes of cervical cancer
Researchers have shown that cervical cancer occurs when cervical cells grow abnormally hence invading other tissues of the feminine body. The invasive nature of cervical cancer hence affects deeper tissues of the cervix which may lead to spreading to other parts of the body. Study has shown that cervical malignancy develops slowly hence its progression has provided chances for prevention and treatment through early detection. The researcher has focused the study in encouraging the mass media to enhance awareness to promote early detection of cervical cancer. Studies have also shown sexually active women to be in high risks of developing cervical activities due to increased hormonal activities.
The risk of developing cervical cancer is associated by infection by HPV. However, some factors such as early exposure to sex, multiple sexual partners, and use of birth control pills increase chances of exposure to HPV. Research has shown different forms of HPV to cause different biological changes in different body tissues which eventually may lead to cancer development.
Men have also played a part in causing cervical cancer in women. Research has shown that unprotected sex especially with uncircumcised males has led to greater exposure to HPV. In Kenya, 15% of males aged between 15-65years have not been circumcised.
Cigarette smoking has also been identified as another factor that causes cervical cancer. The chemicals in the cigarette smoke react with cervical cells hence causing cancerous changes.
2.1.3. Factors that undermine decrease of cervical cancer prevalence
There have been a lot of mythologies and mistaken beliefs that have hindered success in the fight against cervical cancer. These myths prompt off-beam decisions as they rely on fabricated sources of information, especially gossip and rumors. For instance, many women have believed that cervical cancer is equivalent to death sentence. Therefore, to avoid mental stress, these women stay away from cervical cancer screening programs. It is until so late that they show up for screening when the malignancy has developed to several stages, hopelessly curable.
Another key factor is the shortage of facilities required to treat cancer in Kenya. Most victims in Kenya are diagnosed at the advanced levels of the epidemic compared to victims in developed countries such as the United States of America. As a result, cervical cancer mortality rates skyrocket.
Social vices like rapes, prostitution and multiple marriages, and cohabitation have also contributed to cervical cancer prevalence in Kenya. These acts have contributed to the transmission of HPV. According to the United Nations Commission on the Status of Women, 35 percent of women worldwide have experienced sexual injustice by a non-partner in some point in life (UNDP, 2018). Approximately 700 million living women, were married as children. This was the focus of the research as the public ought to know contributions of early marriages in development of malignancy.
Geographical factors such as access to health centers has also contributed to increased prevalence of cervical cancer among Kenyan women. Mostly affected are women living in rural and rustic areas who have lacked means of access to health centers due to poor infrastructure and lack of finances.
2.1.4. Cervical cancer in Kenya
Statistics have shown that a total population of 14.3 million women in Kenya are at a risk of developing cervical cancer. With the poor use of mass media communication and lack of policies and strategies put in place to facilitate early detection of HPV in women, the mortality rates through cervical cancer should be expected to rise if corrective measures are not put in place. Nearly 30% of Kenyan young adults have had sex by the age of 15. Some of which have had little knowledge of protective sex hence they facilitate spread of cancer-causing HPV.
2.1.5. Global statistics regarding cervical cancer
Cervical cancer has been prevalent in many developing countries as they are inhabited by low-income women. HPV has been established to be the main cause of cervical cancer. For instance, HPV 16 and 18 have been found to cause around 70-75% of all cancer types.
The highest rates of cases of cervical cancer have been observed in sub-Saharan Africa, and Central and South America. In 2012, nearly 520,000 women were diagnosed of cervical cancer. In the same year, about 260,000 deaths were observed worldwide of cervical cancer, most of which were due to lack of screening programs. Unfortunately, 90% of these deaths occurred in the developing countries. This has shown that implementation of screening programs has not been well done in the developing countries (Nwabichie et al, 2017).
3. Chapter 3: research methodology
Research methodology is the process used to collect information and data for the purpose of making research decisions. The methodology may include publication research, interviews, surveys, and other research techniques, and could include both present and historical information. This methodology involves the population to be studied, the research design, the sampling strategy, the process of data collection, data gathering tools, data analysis, and data presentation.
3.2. Research Design
The research design refers to the overall strategy that you choose to integrate the different components of the research in a coherent and logical way, thereby, ensuring you will effectively address the research problem; it constitutes the blueprint for the collection, measurement, and analysis of data. The research problem determines the type of design you should use.in our case, we used the descriptive design this research designs help provide answers to the questions of who, what, when, where, and how associated with a particular research problem; a descriptive research cannot conclusively ascertain answers to why. Descriptive research is used to obtain information concerning the current status of the phenomena and to describe ‘what exists with respect to variables or conditions in a situation.
3.3. Target population
This is the entire set of units for which the survey data are to be used to make inferences. Thus, the target population defines those units for which the findings of the survey are meant to generalize. Establishing research objectives is the first step in designing a survey. Defining the target population should be the second step. The researcher targeted women between the age of 15-44 years in Nairobi County.
3.4. Sample Design
A sample design is made up of two elements. Random sampling from a finite population refers to that method of sample selection which gives each possible sample combination an equal probability of being picked up and each item in the entire population to have an equal chance of being included in the sample. This applies to sampling without replacement i.e., once an item is selected for the sample, it cannot appear in the sample again.
3.5. Data Collection Instrument and Procedures
Data collection in research is the primary objective in the completion of a research, the method used was through the distribution of questionnaires. This enabled collection of vital data directly from respondents. Interviews were also being conducted to ensure accuracy, clarity, immediate feedback, and in revealing sensitive data. The method is advantageous because of its direct feedback to the researcher, clarifies certain questions or instructions by the interviewer, probing answers by asking the respondents to clarify their specific responses. The interviewer also supplemented the answers by including their observations.
The questionnaire was divided into four sections: The first part was designed to analyze demographic data, which focused on collecting the respondents’ personality characteristics other personal details to understand the person filling the questionnaires. The second part consisted of questions that were based on the identification of the working environment and how the respondents were affected by it.
The third part of the questionnaire looked at training and development of the respondents. Section four of the questionnaire assessed the impact of the company’s image and reputation. This section consisted of questions with five multiple-choice options for each question, representing different opinions. Pilot research was conducted to test the validity and reliability of the questionnaires. The results of the pilot research were however not included in the final report.
3.6. Data Analysis Methods
Data was collected via questionnaires. SPSS software was used to analyze collected data from multiple respondents in different parts of Nairobi. Descriptive analysis was used to provide the general characteristics of the research population through generating frequency tables, mean, and ranges. The analyzed data was presented via pie charts, graphs, and use of tables which was used to summarize the collected data.
3.7. Research Limitation
The research is limited to one organization and cannot be applied to other similar organizations. Some of the respondents were not free to give some information due to privacy and confidentiality furthermore; respondents may have also given biased information to protect their personal reputation.
Permission was sought from the local area chief before conducting the research. A letter from the institution was also included to indicate the academic purpose of the research, and reassure the maintenance of respondents’ privacy and confidentiality.
3.8. Research ethics
Participation was voluntary through informed consent from the individual respondents. Permission was sought from the local area chief before conducting the data collection exercise.
Acknowledgment was properly made to other people’s work and referenced accordingly in accordance with the requirements. No services of any professional agencies was sought to produce this work except for the data collection and in which only the organization under research was sought. No part or parts of this research shall be used for any purposes other than academic purposes.
3.9. Chapter Summary
This chapter has presented the research methodology that was used in analyzing the research questions. The research population consisted of randomly selected women in Nairobi. The sample size for this research was 15 respondents. The research relied entirely on primary data which was collected from the respondents using a structured questionnaire. Descriptive analysis was used to analyze the results of the research. The results and findings of this research are presented in chapter four.
- Influence of Electronic Media in Creating Cervical Cancer Awareness among Women Seeking Reproductive Health Services at the Kenyatta National Hospital Nairobi, Kenya –Mogoi Ochieng’I Nyambane, Rhoydah (2016).
- Role of print and audiovisual media in cervical cancer prevention in Bangladesh –Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Bangladesh (2013).
- ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in Kenya –Bruni L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S (2018).
- Attitudes, knowledge and perceptions towards cervical cancer messages among female university students –Anne Nattembo (2018).
- Global Burden of Cervical Cancer: A Literature Review –Nwabichie Chinemerem Cecilia1, Rosliza A.M.*2, Suriani I.2 (2017).
- The Weinstein Effect –http://www.ke.undp.org/content/kenya/en/home/blog/2017/the-weinstein-effect–the-global-scourge-of-sexual-harassment.html