Background: Cervical cancer is a public health concern worldwide, and is increasing in developing countries. Despite the efforts of governments, demand for cervical cancer screening is low and not well studied. As such, this study was done to figure out the demand for cervical cancer screening in Tigray regional state. Methods: A cross-sectional study design was conducted, and 1,010 participants were recruited using simple random sampling. Data were collected using an intervieweradministered questionnaire, and analysis was done using multilevel logistic regression. Results: A total of 1,000 women were included in the final analysis. The mean age of participants was 32.57±8.56 years. Those demandeing cervical cancer screening numbered 480 (48%). Intraclass correlation indicated that 18.9% of the total variance in demand was attributable to differences across the cluster districts (p0.0001). Predictors of demand for cervical cancer screening were age 31-40 years (AOR 2.33, 95% CI 0.42-3.83) and 41-45 years (AOR 3.02, 95% CI 1.64-5.55), tertiary education (AOR 2.81, 95% CI 1.43-5.51), history of sexually transmitted disease (AOR 1.71, 95% CI 1.05-2.79), being knowledgeable about cervical cancer, (AOR 9.21, 95% CI 5.79-14.65), and having a positive attitude toward cervical cancer screening (AOR 8.32, 95% CI 5.53-12.51). Among community level variables, community awareness of cervical cancer and population:health institution ratio were factors associated with demand. Conclusion: Demand for cervical cancer screening is low compared to the government's plan for 2020. Health professionals and leaders need to focus on communit-level demand creation for cervical cancer screening by planning health-promotion strategies.
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