Background Cervical cancer is a global public health problem with marked geographical disparity. High morbidity and mortality rates in developing countries are associated with low screening rates. In 2020, in Rwanda, 3.7 million women aged 15–59 years were at risk of developing cervical cancer, the most commonly diagnosed female cancer in Rwanda. Despite Rwanda being the first African country to vaccinate against human papilloma virus with a three-dose regimen vaccination coverage of nearly 93% in the target population of girls aged <15 years, and having established cervical cancer screening program, recent studies have found low screening rates. Our study sought to determine knowledge, motivators and barriers of cervical cancer screening. Methods We conducted a qualitative descriptive study; using focus group interview in an urban health facility (Muhima district hospital) and a rural health center (Nyagasambu health center) offering cervical screening services in Rwanda. Participants were women seeking these services and other women attending the health facility for any reason, and female staff working in these facilities. Interviews were recorded and transcribed, and data were analyzed using content analysis. Results Thirty women participated in focus group interview, with an average age of 39 years. Many of women showed knowledge about cervical cancer existence and prevention methods. However, fear for pain, lack of knowledge about screening, how and where the screening was done, and concern for privacy were recurring subthemes. Some participants also mentioned lack of health insurance as a barrier for cervical cancer screening. Conclusion Barriers to uptake cervical cancer screening services in Rwanda are related to poor information about cervical cancer and the importance of screening as well as non-adherence to medical insurance. Population sensitization through campaign and community outreach activities could have a positive impact on increasing the usage of cervical cancer screening in Rwanda.

Background: Cervical cancer is a global public health problem with marked geographical disparity. There are high morbidity and mortality rates in low- and middle-income countries (LMICs) associated with low screening rates. In 2020, in Rwanda, 3.7 million women aged 15–59 years were at risk of developing cervical cancer. It is the most commonly diagnosed female cancer in Rwanda with an incidence rate of 42 cases per 100,000 women per year. Despite Rwanda being the first African country to vaccinate against human papillomavirus (HPV) with a three-dose regimen, vaccination coverage of nearly 93 % in the target population of girls aged < 15 years, and having an established cervical cancer screening program, recent studies have found low screening rates. Our study sought to determine knowledge, motivators, and barriers to cervical cancer screening.Methods: This was a qualitative phenomenological study conducted in an urban health facility (Muhima district hospital) and a rural health center (Nyagasambu health center) offering cervical screening services in Rwanda. Focus group discussion (FGD) participants were women seeking these services and other women attending the health facility for any reason, as well as female staff working in these health centers. We also interviewed a key informant (KI) from the national organization. FGD and KI interviews were recorded and transcribed, and the data were analyzed using thematic analysis.Results: Thirty women were enrolled in the FGDs, with an average age of 39 years. Many FGD women showed knowledge about cervical cancer existence and prevention methods. However, fear for pain, lack of knowledge about screening, how and where the screening was done, and privacy concerns were recurring subthemes. Key-informant and some FGDs participants have also mentioned a lack of health insurance as a possible barrier for cervical cancer screening.Conclusions: Barriers to the utilization of cervical cancer screening program in Rwanda are related to poor information about cervical cancer and the importance of screening among women, as well non-adherence to medical insurance schemes. Population sensitization through campaign and community outreach activities could have a positive impact on increasing the uptake of cervical cancer screening in Rwanda.