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Communication Issues Regarding Control of Cervical Cancer
among Rural Women in Elgeyo-Marakwet County, Kenya

$i'tori C(ep)e*oi +utto
,oi -niversity% S'(ool o. /u*n 0esour'e Develop*ent% Deprt*ent o. Co**uni'tion Studies
P.#. 1o2 34&6% 4ldoret% Code 50&00
4*il6 vi')y)ip)eu7y(oo.'o.u)

Abstract
8(e pper loo)s t t(e *et(odology o. 9ulittive study on :Co**uni'tion C(llenges in t(e Control o.
Cervi'l Cn'er ;*ong 0url <o*en= study t(t is t t(e stge o. dt nlysis. 8(e reser'( t)es
p(ilosop(i'l stn'e o. t(e reltivist trdition nd t(us uses 9ulittive ppro'( to develop t(e
p(eno*enologi'l study. 8(is pper see)s to e2plore t(e '(llenges .'ing 9ulittive reser'( in t(e >')drop
o. so'iety w(ere 'redi>le reser'( (s o.ten >een viewed s t(t w(i'( (s >een 'ondu'ted 9untittively% wit(
9ulittive spe'ts used only to >ring out des'riptively t(e .indings t t(e til end o. t(e study. 8(is pper pys
ttention to spe'ts o. s*pling% reser'( instru*ents% dt genertion% dt nlysis nd trustwort(iness in
9ulittive reser'(. 8(e pper lso gives su**ry o. *et(odologi'l '(llenges .'ing t(is 9ulittive study.
In t(e pre*>le o. t(e pper generl insig(t o. t(e pro?e't is given% nd t t(e end% su**ry o. so*e o. t(e
.indings is outlined.
Keywords6 Co**uni'tion% 'ervi'l 'n'er% rurl wo*en% 9ulittive reser'(

! Introduction
8(is reser'( is n ongoing p(eno*enologi'l study w(i'( e2plores vrious '(llenges t(t rurl wo*en re
.'ed wit( in 'o**uni'ting 'ervi'l 'n'er% disese t(t is stedily >e'o*ing 'o**on 'n'er *ong
wo*en nd 'use o. det(% espe'illy in su>-S(rn ;.ri' (IC#@</# 20&0!. 8(e pro?e't gives
>')ground into t(e (istory o. 'n'er in generl nd (ow it (s >een disese o. p(eno*enl >urden to
(u*nity over t(e ges. 8(e pro?e'tAs *in stte*ent o. t(e pro>le* is t(t w(eres reser'( nd te'(nology
(ve reliBed gret positive innovtion in t(e 'ontrol o. 'ervi'l 'n'er in ter*s o. prevention% esy to d*inister
nd less invsive dete'tion nd tret*ent pro'edures% t(e disese 'ontinues to >e 'o**only o''urring 'n'er
*ong wo*en wit( in'iden'e nd *ortlity rtes going (ig(er e'( yer. 8(e purpose o. t(e p(eno*enologi'l
study is to s(ed lig(t on w(t 'onstitutes 'o**uni'tion '(llenges in t(e 'ontrol o. 'ervi'l 'n'er nd t(e
results re (oped to 'ontri>ute to )nowledge t(t will (elp '(ieve t(e .our 'o*ponents o. 'n'er 'ontrol6
prevention% dete'tion% tret*ent nd pllitive 're% >y de>un)ing t(e *yt(s t(t surround 'ervi'l 'n'er 'ontrol.
8(e reser'( 9uestions o. t(e study re6
! /ow do rurl wo*en 'o**uni'te t(eir e2perien'es o. 'ervi'l 'n'erC
>! <(t )ind o. 'o**uni'tion on 'ervi'l 'n'er do rurl wo*en (ve ''ess toC
'! <(t is t(e 'o**uni'tion e2perien'e o. rurl wo*en in ''essing (elt('re .or 'ervi'l 'n'erC
d! /ow does stig*tiBtion o. 'n'er in pu>li' sp(ere 'ontri>ute to 'o**uni'tion '(llenges in t(e 'ontrol o.
'ervi'l 'n'erC
e! <(t is t(e prti'iptory level o. rurl wo*en in '*pigns .or 'o**uni'ting 'ervi'l 'n'erC
8(e geogrp(i' s'ope o. t(e study is li*ited to 4lgeyo ,r)wet 'ounty in +eny. 8(e s'ope o. t(e 'ontent is
li*ited to t(e so'il perspe'tive o. 'ervi'l 'n'er 'ontrol s .r s 'o**uni'ting t(e disese is 'on'erned. 8(e
*et(odologi'l s'ope is li*ited to 9ulittive ppro'( o. in9uiry.
8(e reser'( is >')ed >y literture review. In t(is '(pter% n overview is given o. 'n'er nd su> topi's
dis'ussing spe'ts o. t(e reser'( 9uestions o. t(e study is dis'ussed. 8(e literture review lso loo)s t relted
studies in order to est>lis( t(e gp t(t *otivted t(is reser'(. 8(e t(eoreti'l nd 'on'eptul .r*ewor) is
lso given in t(e '(pter o. t(e literture review. 8(e t(eories t(t guide t(e study re develop*ent
'o**uni'tion t(eories nd so'il 'ognitive t(eory.
8(e *et(odology o. t(e pro?e't is p(ilosop(i'lly >sed on reltivist ontology. 8(e episte*ology o. t(e study is
interpretivist- 'onstru'tivist >e'use t(e (u*n person is t(e *in sour'e o. dt nd toget(er wit( t(e
reser'(erD t(ey interpret nd 'onstru't t(e )nowledge soug(t in t(e reser'(. 8(e prdig* o. t(e study is o.
prti'iptory worldview nd dvo''y s el>orted >y Creswell (2007!% DenBin nd Ein'oln (200"!% Ponterroto
(200"! nd Ein'oln nd Fu> (&G3"!. 8(e study is t(ere.ore developed s nturlist in9uiry using
p(eno*enology to e2plore t(e lived e2perien'es o. wo*en wit( 'ervi'l 'n'er nd lso to interrogte
)nowledge levels o. rurl wo*en s .r s wreness o. 'ervi'l 'n'er is 'on'erned. 8(e study uses
9ulittive ppro'( in sele'ting t(e s*ple o. t(e reser'(% developing reser'( instru*ents% dt genertion
nd dt nlysis. 8(e dt is nlysed using t(e*ti' nlysis. Sin'e t(e reser'( uses (u*n prti'ipnts .or
dt genertion% ll t(e ne'essry steps were t)en to ensure et(i'l 'onsidertion were put in pl'e. 4t(i'l
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'lern'e 'erti.i'te .or t(e study ws issued >y t(e Institute o. 0eser'( nd 4t(i'l Clern'e (I04C! o. ,oi
-niversity% nd reser'( per*it issued >y t(e Ntionl Coun'il o. S'ien'e nd 8e'(nology (NCS8!.
8(e reser'( pro?e't lso gives n overview o. t(e .ield e2perien'es o. t(e reser'(er prti'ulrly on t(e
'(llenges .'ed in e2ploring topi' t(t is s(rouded in *yt( nd ne'dote% nd t(e ulti*te .er o. det(.

"! Met#odology
2.1 Introduction
In t(is '(pter% t(e reser'( *et(odology is dis'ussed. It strts wit( t(e p(ilosop(i'l stn'e o. t(e study t(en
.ollowed >y dis'ussion o. t(e reser'( ppro'(. 8(e '(pter lso e2pounds on t(e lo'tion o. t(e study nd
t(e trget popultion. 8(e in'lusion nd e2'lusion 'riteri re dis'ussed to e2plin w(y t(e '(oi'e o. t(e trget
popultion ws *de. 8(is is .ollowed >y dis'ussion on t(e study s*ple nd t(e s*pling te'(ni9ues
e*ployed on t(e study. Dis'ussed lso is t(e developing o. reser'( instru*ents% dt genertion pro'edures%
dt nlysis nd interprettion. 8(is '(pter lso gives t(e trustwort(iness o. t(e reser'( .ollowed >y et(i'l
'onsidertions nd .inlly t(e .ield e2perien'es.
2.2 Philosophical Paradigm
8(is study su>s'ri>es to t(e ontology o. reltivist trdition. ;''ording to Ho(nson (2003! in Hwn nd #ngondo
(20&&! t(ere is no single view point o. t(e world nd t(ere.ore relity is su>?e'tive. 8(t is% relity is internl to%
nd dependnt on t(e individulIs per'eptions nd e2perien'es. ,son (2002! .urt(er e2plins t(t t(ere is no
o>?e'tive relity >ut *ultiple relities so'illy nd 'ulturlly 'onstru'ted >y individuls .ro* wit(in t(eir own
'onte2tul interprettion. 8(is study is on 'o**uni'tion '(llenges in t(e 'ontrol o. 'ervi'l 'n'er nd t(e
reser'( 9uestions guiding t(e study revolve round disese t(t (s >een p(eno*enon to (u*nity over t(e
ges. Jro* t(e .ield dt generted t(ere re *ultiple relities so'illy nd 'ulturlly 'onstru'ted regrding
'n'er .ro* wit(in t(e 'onte2tul interprettion o. t(e reser'( 'o**unity. It is .ro* t(is 'o*ple2 stndpoint
t(t t(e reser'( e2plores t(e 'o**uni'tion '(llenges rising in t(e 'ontrol o. 'ervi'l 'n'er *ong rurl
wo*en.
Cervi'l 'n'er is one o. t(e 'n'ers t(t (s seen vrious te'(nologi'l nd innovtive dvn'es in reser'(%
*)ing it one o. t(e esiest 'n'ers to prevent% dete't nd tret (t t(e erly stges! using si*ple nd less
invsive *et(ods% >ut ironi'lly% it is still rn)ed one o. t(e 'o**onest 'n'ers in in'iden'e nd *ortlity
espe'illy in Su>-S(rn ;.ri' (</#% 2003% </#@IC# 20&0!. 8(is reser'( sw gp in 'o**uni'tion
t(t leves t(e rurl wo*n on one end nd t(e positive dvn'es o. *edi'l reser'( on t(e ot(er end%
'onse9uently leving 'ervi'l 'n'er to 'ontinue rising in its rvges *ong wo*en. 8(is study t(ere.ore grees
wit( ,son (2002! t(t it is only on'e we re'ogniBe t(t lterntive ontologi'l perspe'tives *ig(t tell di..erent
ontologi'l views o. t(e so'il world s position w(i'( s(ould >e est>lis(ed nd understood% rt(er t(n n
o>vious universl trut( w(i'( 'n >e t)en .or grnted. In regrd to t(e 'ontrol o. 'ervi'l 'n'er% t(e .'t
*edi'l reser'( (s yielded positive dvn'es s(ould not >e t)en .or grnted t(t t(is will uto*ti'lly give
solution to 'ontrolling t(e rising 'ses o. t(e disese. 8(is reser'( t)es n ontologi'l stn'e o. t(e reltivist
trdition to e2plore t(e pro>le*ti' .ro* so'il perspe'tive wit( t(e *in .o'us on 'o**uni'tion. /ow
'o**uni'tion t)es pl'e >etween t(e rurl wo*n nd t(e relevnt in.or*tion >odies on 'ervi'l 'n'er% is
o. 'on'ern to t(is study. 8(ere e2ist *ultiple relities in ter*s o. >elie.s nd 'ulture w(i'( re9uire de>un)ing in
order to step up 'ervi'l 'n'er 'ontrol% nd t(is leds to t(e dis'ussion o. t(e episte*ology o. t(is study.
;''ording to Hwn nd #ngondo (20&&! episte*ology is t(e nture o. eviden'e nd )nowledge% t(e rules nd
prin'iples >y w(i'( we de'ide w(et(er nd (ow so'il p(eno*en 'n >e )nown nd (ow )nowledge 'n >e
de*onstrted. 8(is study too) t(e interpretivist-'onstru'tivist episte*ologi'l stn'e w(ere t(e (u*n person is
t(e *in sour'e o. dt genertion. Issues o. 'on'ern in t(e study were interpreted .ro* t(e dilogi'l pro'ess
>etween reser'(er nd prti'ipnts nd )nowledge 'onstru'ted resulting .ro* t(e s*e dilogi'l pro'ess.
Interpretivist-'onstru'tivist episte*ology i*s t generting dt .ro* people t(e*selves wit( t(e gol o.
getting )nowledge >out (ow people per'eive% interpret nd understnd issues t(t ..e't t(e* in t(eir own
'onte2ts. 8(e interpretivist ppro'( sees people s pri*ry sour'e o. dt nd s (ving t(e insider view .ro*
w(i'( t(ey per'eive nd interpret w(t ..e'ts t(e* giving it individul or 'olle'tive *ening.
8(is study soug(t to e2plore t(e '(llenges o. 'o**uni'tion in t(e 'ontrol o. 'ervi'l 'n'er *ong rurl
wo*en t(roug( interviews nd Jo'us Dis'ussion Froup nd t(e tenets o. t(e interpretivist-'onstru'tivist
episte*ology were >orne in *ind in t(e dt genertion pro'ess
8(e spe'i.i' prdig* t(t t(e study ws grounded in% is t(e prti'iptory worldview nd dvo''y prdig*
w(i'( see)s to >ring toget(er 'tion nd re.le'tion% t(eory nd pr'ti'e in prti'iption wit( ot(ers in pursuit o.
pr'ti'l solutions to issues o. pressing 'on'ern to people ( Ein'oln Fu> &G3"D nd Ponterotto 200"!. 8(e
prti'iptory worldview nd dvo''y prdig* ulti*tely see)s t(e .louris(ing o. individul persons nd t(eir
'o**unities. In see)ing to >re) t(e >rriers o. 'o**uni'tion in t(e 'ontrol o. 'ervi'l 'n'er *ong rurl
wo*en% t(is study (opes to 'ontri>ute *ening.ully to t(e lives o. *rginliBed groups w(ose l') o. wreness
nd l') o. )nowing (ow to 'o**uni'te t(eir pro>le*% results in disese >urden nd det(. 8(is prdig* (s
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*ultiple trut(s t(t re ti*e nd 'onte2t >ound w(ere 'ertin trut(s re privileged w(ile ot(ers re *rginliBed.
In t(is study in.or*tion nd )nowledge on 'ervi'l 'n'er is viewed s privileged to t(e *ore ur>n nd (ig(er
liter'y level 'o**unities >ut *rginliBed to t(e *ore rurl nd low liter'y level 'o**unities. 8(e
prti'iptory worldview nd dvo''y prdig* posits t(t t(e reser'(er nd prti'ipnts re *utully
in.luentil nd t(eir reltions(ip s(ould ulti*tely 'rete positive '(nge. $lues s(ould in.luen'e in9uiry su'(
t(t positive so'il '(nge results.
8(is study is Nturlists In9uiry (NI! nd t(e (u*n person is t(e *in sour'e o. dt. In line wit( t(e
prti'iptory worldview nd dvo''y prdig*. ;''ording to Flser (2005! nd Ein'oln nd Fu> (&G3"! o.
i*portn'e is t(e nturl setting o. t(e prti'ipnts% s relities re w(oles w(i'( 'nnot >e understood in
isoltion. In t(is study t(e ulti*te gol is to 'rete )nowledge t(t will *)e rurl wo*en 'o**uni'te *ore
openly nd *ening.ully >out 'ervi'l 'n'er so t(t *ore go .or s'reening nd erly tret*ent. 8(us
interviews nd JFDs were 'ondu'ted wit(in t(eir nturl settings nd *ong people t(ey live nd sso'ite wit(.
In Nturlisti' In9uiry (NI! negotited out'o*es re soug(t. ;''ording to Flser (2005! NI pre.ers to negotite
*ening nd interprettion wit( (u*n sour'es .ro* w(i'( t(e dt (s '(ie.ly >een drwn. 8(is is >e'use it is
t(eir 'onstru'tions o. relity t(t t(e in9uirer see)s to re'onstru't sin'e in9uiry out'o*es depend upon t(e nture
nd 9ulity o. t(e inter'tion >etween )nower nd )nown.
In t(is reser'( t(e prti'ipnts were in t(eir nturl rurl setting in t(eir (o*es% .or individul interviews% w(ile
t(e prti'ipnts in t(e JFDs were lso in t(eir nor*l setting in t(e rurl environ*ent wit( people t(ey o.ten
inter't wit(. Ein'oln nd Fu> (&G3"! nd 4rlndson (&G35! outline i*ple*enttion ele*ents w(i'( re lso
e*p(siBed >y Flser (2005!% nd t(is reser'( su>s'ri>es to. 8(ese ele*ents re6 *)ing initil 'ont't nd
gining entire to t(e siteD negotiting 'onsent% >uilding nd *intining trust% nd indenti.ying nd using
in.or*nts.
In order to gin entry% rrnge*ents were *de .or initil 'ont't nd gining entry soug(t so t(t prti'ipnts
lso >e'*e wre o. t(e i*pending reser'( pro'ess. ;ll t(e reser'( prti'ipnts 'li*ed t(t t(ey (d no
prior e2perien'e wit( reser'( persons nd t(ere.ore t(ere ws need to *)e t(e* understnd t(e pro.undity o.
prti'iption.
Negotiting 'onsent ws dee*ed i*portnt >e'use t(e study dwelt on sensitive topi' on illness w(ose
lo'tion in t(e (u*n person is in t(e *ore o. privte do*in. <(ere individul ptients were o. .ir (elt( nd
>le to 'onverse wit( t(e reser'(ers .reely% 'onsent ws negotited on .'e to .'e >sis. <(ere t(e ptient
ws not in very good (elt( >ut willing to prti'ipte% 'onsent ws negotited t(roug( 'regivers nd .*ily so
t(t ll et(i'l 'on'erns were o>served.
1uilding nd *intining trust ws ssured t(roug( sin'ere inter'tion wit( t(e prti'ipnts nd repeted visits.
8(ere ws use o. pproprite 'o**uni'tion s)ills su'( s using t(e lo'l dile't nd >lending wit( t(e
prti'ipnts wit(out *u'( inter.eren'e wit( t(eir dy to dy 'tivities. ;llowing t(e prti'ipnts to understnd
t(e pro'ess o. dt 'olle'tion li)e t(e use o. re'order nd '(e')ing t(eir 'onverstion .ro* ti*e to ti*e lso >uilt
n en>ling environ*ent .or trust.
In.or*nts nd gte)eepers were identi.ied to (elp in getting to prti'ipnts nd lso *)ing prior rrnge*ents
.or visits. 8(ey lso ssisted in (ndling ny e*ergent issues w(ere t(ere ws dou>t or '(nge o. *ind >y
prti'ipnts. In.or*nts nd gte)eepers 'onsisted *inly o. elders nd d*inistrtion st.. su'( s '(ie.s% nd
ssistnt '(ie.s in t(e villge level.
1y o>serving ll t(e tenets o. NI% t(e study ws 'ondu'ted in line wit( t(e reltivist p(ilosop(i'l trdition
idiogrp(i' *et(ods s will >e e2plined in t(e ne2t se'tion on t(e ppro'( o. t(e reser'(.
2.3 Research Approach
8(is is 9ulittive reser'(. 8(e 9ulittive ppro'( ws used to i* t 'reting understnding dt s
nlysis pro'eeded. 8(e ppro'( ws .le2i>le to e*ergent issues nd 'ir'u*stn'es in t(e reser'( pro'ess
>e'use *ost o. t(e interviews were 'ondu'ted t t(e prti'ipntIs 'o*.ort. Ptients were interviewed in t(e
'o*.ort o. t(eir (o*e environ*ent w(ile JFDs were 'ondu'ted w(ere t(e wo*en operted .ro* su'( s t(eir
>usiness venue or in t(e (o*e w(ere t(ey (d t(eir group *eetings. 8(ere ws openness to dpting situtions to
'(nge. 8(is .le2i>ility in t(e reser'( ppro'( is given support >y Ptton (2002! w(o notes t(t t(e 9ulittive
ppro'( is .le2i>le% nd t(is is to t(e dvntge o. t(e reser'(er. ;''ording to Ptton t(e reser'(er is >le to
void getting lo')ed into rigid designs t(t eli*inte responsiveness nd t(e >ility to pursue new pt(s o.
dis'overy s t(ey e*erge. In t(is study 9ulittive ppro'( ws pre.erred >e'use t(e i* o. t(e reser'( ws
to unrvel p(eno*enon >y engging wit( t(e prti'ipnts in de>un)ing *yt(s t(t (ve 'ontri>uted to
'o**uni'tion '(llenges in t(e 'ontrol o. 'ervi'l 'n'er.
P(eno*enology (s >een used s *et(od o. t(is NI to e2plore t(e lived e2perien'es o. rurl wo*en in
'o**uni'ting 'ervi'l 'n'er in n tte*pt to nlyBe 'o**uni'tion '(llenges in t(e 'ontrol o. 'ervi'l
'n'er. ;''ording to /ollowy (&GG7! p(eno*enology is used in reser'( .or gining insig(t into peopleIs
*otivtions nd 'tions% nd 'utting t(roug( t(e 'lutter o. t)en .or grnted ssu*ptions nd 'onventionl
wisdo*. 1ry)'Byns)i nd 1enner (20&0! e2plin t(t p(eno*enology reser'( in interpretivist episte*ologies
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(s evolved s *et(odology over ti*e t(roug( vrious reser'( res% *ong t(e* studies o. (u*n
e2perien'es o. (elt( nd illness% nd (s given lnguge to :t)en-.or-grnted res o. pr'ti'l wisdo*% s)illed
)now (ow nd *otions o. good pr'ti'e.= In t(is study on 'o**uni'tion '(llenges in t(e 'ontrol o. 'ervi'l
'n'er% t(e t)en-.or-grnted stn'e lies in t(e ssu*ption t(t wo*en re wre o. t(e .our 'o*ponents o.
'n'er 'ontrol6 prevention% s'reening% tret*ent nd pllitive 're. ;nd i. t(is (d >een t(e 'se% t(en wo*en
s(ould >e .ree o. 'ervi'l 'n'er or t t(e worst% re >le to ''ess (elt('re .or t(e *nge*ent o. t(e disese.
/owever t(e relity is t(t wo*en re 'ontinuing to su..er t(e rvges o. 'ervi'l 'n'er s indi'ted >y
vil>le sttisti's s illustrted in t(e >')ground in.or*tion nd literture review o. t(is study.
;''ording to Eester (&GGG! t(e purpose o. p(eno*enologi'l ppro'( is to illu*inte t(e spe'i.i's% to identi.y
p(eno*en t(roug( (ow t(ey re per'eived >y t(e 'tors in rurl wo*en nd t(e issue o. 'on'ern is
'o**uni'tion '(llenges t(ey .'e in t(e 'ontrol o. 'ervi'l 'n'er. Eester .urt(er e2plins t(t
p(eno*enology is gt(ering .ro* people KdeepI in.or*tion nd per'eptions t(roug( indu'tive% 9ulittive
*et(ods su'( s interviews% dis'ussions nd prti'ipnt o>servtion% nd representing it .ro* t(e perspe'tive o.
t(e reser'( prti'ipnts. 8(is pplies .or t(is prti'ulr study lt(oug( it is li*ited only to individul interviews
nd Jo'us Froup Dis'ussions (JFDs!.
Eester .urt(er el>ortes t(t p(eno*enology lso involves K>r')etingI t)en .or grnted ssu*ptions nd usul
wys o. per'eiving. 8)en .or grnted in t(is study s .r s generl so'iety is 'on'erned is t(e .'t t(t wo*en
re wre >out nd (ve ''ess to in.or*tion nd 'n 'o**uni'te >out 'ervi'l 'n'er. P(eno*enology is
>sed on ppro'(es >sed on personl )nowledge nd su>?e'tivity. It see)s to des'ri>e rt(er t(n e2plin nd
is .ree .ro* per'eption or pre'on'eptions. Eester lso e2plins t(t p(eno*enologi'l *et(ods re e..e'tive t
>ringing to t(e .ore t(e e2perien'e .ro* peopleIs own perspe'tives. In t(is study t(e lived e2perien'es o. wo*en
su..ering .ro* 'ervi'l 'n'er re interrogted in n tte*pt to understnd t(eir )nowledge levels nd
'onse9uently ssess t(eir 'o**uni'tion '(llenges in t(e 'ontrol o. t(e disese. Eester .urt(er posits t(t
p(eno*enologi'l reser'( dds interpretive di*ension t(t (elps to support or '(llenge poli'y nd 'tion. 8(is
study loo)s t t(e .indings o. t(e .ield reser'( wit( t(e i* o. interpreting t(e i*pli'tion o. t(e perspe'tives
t(t t(e prti'ipnts (ve in t(e lig(t o. 'ervi'l 'n'er 'ontrol.
2.4 The Location of the Study
8(is study ws 'rried out in 4lgeyo ,r)wet County in +eny. 8(e prti'ipnts were ll in t(eir lo'l rurl
setting. 8(e individuls were identi.ied .ro* t(e 'o**unity or tr'ed t(roug( (ospitl re'ords. 8(e prti'ipnts
in JFDs were ordinry rurl wo*en in t(eir dy to dy 'tivities t(t >ring t(e* to wor) toget(er li)e t t(e
*r)et or wo*en group *eetings. ;ll t(e prti'ipnts lived in 4lgeyo ,r)wet 'ounty nd 'rry out t(eir dy
to dy 'tivities in t(e 'ounty. 8(e study ws lo'ted *inly in rurl prts o. t(e 'ounty% lt(oug( *ost o.
4lgeyo ,r)wet 'n >e sid to >e generlly rurl in 'o*prison to ot(er 'ounties in t(e 'ountry t(t (ve
est>lis(ed ur>n in.rstru'ture.
2. Target Population and Sample Si!e
8(e prti'ipnts were rurl wo*enD ptients o. 'ervi'l 'n'er .or individul interviews nd ny rurl wo*en
were eligi>le to prti'ipte in t(e JFDs. 8(e entire nu*>er o. prti'ipnts ws .i.ty .ive wo*en. 8(e individul
'ervi'l 'n'er ptients interviewed were .i.teen wo*en. 8(ey gve personl ''ounts o. t(eir lived e2perien'es
in *nging t(eir 'ondition.
Jorty wo*en% in groups o. ten e'( were sele'ted to prti'ipte in t(e JFDs. 8(ese were ny wo*en not
ne'essrily su..ering .ro* 'ervi'l 'n'er. 8(e '(oi'e to in'lude wo*en w(o were supposedly .ree .ro*
'ervi'l 'n'er ws i*portnt to t(is reser'( >e'use t(e 'ontrol o. 'ervi'l 'n'er is lrgely pegged on
wreness in order to en>le wo*en to prevent or see) erly tret*ent .or t(e disese. 8(e JFDs i*ed t
interrogting )nowledge levels o. rurl wo*en nd t(e '(llenges t(ey re .'ed wit( in 'o**uni'ting 'ervi'l
'n'er. 8(is ws to est>lis( t(e pro>>le 'use .or wo*en not see)ing (elt('re erly enoug( w(en prevention
or tret*ent is still possi>le.
2." #$clusion and Inclusion %riteria
8(e prti'ipnts in t(e reser'( re wo*en. In t(e individul interview s'(edules% ptients o. 'ervi'l 'n'er re
interviewed in order .or t(e* to give personl ''ounts o. t(eir lived e2perien'es s t(ey *nge t(eir 'ondition.
In t(e JFDs rurl wo*en w(o re presu*>ly .ree .ro* 'ervi'l 'n'er re t(e prti'ipnts in t(e dis'ussion.
8(e '(oi'e to in'lude t(is 'tegory is to interrogte t(e wreness levels o. wo*en s .r s 'ervi'l 'n'er is
'on'erned. 8(e ge >r')et o. wo*en interviewed is t(irty yers nd >ove. 8(e resons .or t(is '(oi'e re t(t%
.irst% >elow t(e ge o. t(irty yers so*e young wo*en *y not (ve engged in se2ul de>ut% nd se2ul
inter'ourse is t(e *in 'use o. t(e spred o. t(e /P$ virus t(t 'uses 'ervi'l 'n'er (</# 2002!. Se'ondly%
t(e (u*n >ody is 'p>le o. .ig(ting o.. t(e /P$ virus in *ost wo*en >elow t(e ge o. t(irty yers (i>id!.
2.& Sampling Procedure
8(is >eing 9ulittive study t(e s*ple siBe ws .irly s*ll >e'use t(e individul interviews nd t(e Jo'us
group dis'ussions (JFDs! were intense. S*pling ws done wit( .o'us on in.or*tion ri'( 'ses% .or n in-dept(
study. ;''ording to ,ills% Durepos L <ie>e (20&0! lrge s*ple in 9ulittive study would (inder n in-
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dept( study >e'use it would >e di..i'ult to pro'ess t(e lrge output o. dt. 8(us s*ller s*ple would llow
t(e pro'ess to e2tr't t(i') ri'( dt. 1ut to '(ieve >ln'e s noted >y Sndelows)i (&GG"!% t(e s*ple ws
not too s*ll s to in(i>it dt sturtion. 8(e study lso pid ttention to t(e 'ution >y Ein'oln nd Fu> (&G3"!
t(t t(e s*ple s(ould not >e too s*ll to '(ieve n in.or*tionl redundn'y% point in 9ulittive nlysis
w(ere dt 'nnot yield ny*ore new in.or*tion
8(e study pid ttention to t(e i*portn'e o. sturtion nd t(us s*ll s*ple ws pre.erred s ,son (20&0!
dvises t(t s*ples .or 9ulittive studies s(ould >e generlly *u'( s*ller t(n t(ose used in 9untittive
studies. ,son .urt(er 9uotes 0it'(ie% Eewis nd 4l* (2005! w(o give resons .or s*ller s*ple .or
9ulittive study. ;''ording to 0it'(ie et l t(ere is point o. di*inis(ing return to 9ulittive s*ple M s t(e
study goes on% *ore dt does not ne'essrily led to *ore in.or*tion. In t(is study w(ere wo*en were
interviewed on 'ervi'l 'n'er wreness% t(ere ws re'(ed point w(ere t(e ltter interviewees gve si*ilr
in.or*tion to t(e previous ones. 0it'(ie et l e*p(siBe t(t one o''urren'e o. pie'e or 'se is ll t(t is
ne'essry to ensure t(t it >e'o*es prt o. t(e nlysis .r*ewor). 8(e .re9uen'ies re rrely i*portnt.
Sndelows)i (&GG"! nd ,son (20&0! gree t(t 9ulittive s*ples s(ould >e lrge enoug( to ssure t(t *ost
or ll o. t(e per'eption t(t *ig(t >e i*portnt re un'overed% >ut t t(e s*e ti*e s(ould not >e too lrge s to
>e repetitive nd eventully super.luous. In t(is study% t(e s*ple ensured t(t sturtion on issues ddressed >y
t(e reser'( 9uestions were dis'ussed wit( t(e prti'ipnts to point w(ere t(e interviews nd JFDs did not
s(ed ny .urt(er lig(t to t(e issues under investigtion.
8(e study used non-pro>>ility s*pling te'(ni9ues to rrive t t(e s*ple siBes .or t(e individul interviews
nd JFDs. 8(e study use purposive s*pling to get t(e s*ple o. .i.teen wo*en w(o prti'ipted in t(e
individul interviews. 8(ese were wo*en su..ering .ro* 'ervi'l 'n'er. ;''ording to Ptton (2002! in
purposive s*pling% t(e people re sele'ted >e'use t(ey re in.or*tion ri'( nd illu*intive% nd o..er use.ul
*ni.esttions o. t(e p(eno*enon o. interest. Sin'e t(ere ws no vil>le list o. wo*en su..ering .ro* 'ervi'l
'n'er in t(e 4lgeyo-,r)wet County% snow>lling ws t(e pre.erred *et(od o. sele'ting prti'ipnts. 1>>ie
(200G! e2plin snow>lling s non-pro>>ility s*pling *et(od t(t is used w(en t(e *e*>ers o. spe'il
popultion re di..i'ult to lo'te. In t(is study% getting wo*en su..ering .ro* 'ervi'l 'n'er in 4lgeyo-
,r)wet County ws not si*ple strig(t.orwrd ts) >e'use t(e ptients were s'ttered in di..erent lo'tions
nd lso et(i'l 'on'erns (d to >e 're.ully ddressed (s will >e e2plined lter in t(e '(pter!. ;''ording to
+oe>er nd ,',i'(el (2003! snow>lling s*pling *et(od strts wit( t(e individuls w(o will prti'ipte in
t(e study nd w(o will lso (elp in lo'ting ot(er prti'ipnts. 8(is study used t(is *et(od to lo'te t(e wo*en
wit( 'ervi'l 'n'er nd t(e dvntge ws t(t t(e reser'(er in turn got good introdu'tion .or t(e ne2t
interview wit(out ppering to intrude into prti'ipnt personl sp'e. 8(e trget popultion t(en grew .ro*
s*ll nu*>er to t(e desired nu*>er o. prti'ipnts s t(e study progressed. In t(is study t(e wo*en prti'ipnts
w(o were ptients o. 'ervi'l 'n'er indenti.ied ot(ers wit(in t(eir lo'lity >e'use o. t(eir si*ilr
'ir'u*stn'es w(i'( o.ten >roug(t t(e* toget(er prti'ulrly s t(ey soug(t tret*ent or lterntive t(erpies.
Jor t(e (JFDs! s*ple% t(e 9uot s*pling te'(ni9ue ws used to get t(e .our wo*en groups o. ten prti'ipnts
e'(. 8(e '(oi'e o. 9uot s*pling ws rrived t >e'use t(is ws seen s t(e >est *et(od to (ve
representtion o. wo*en .ro* t(e 4lgeyo ,r)wet County w(i'( is *de up o. two distri'tsD +eiyo nd
,r)wet. 8wo groups were sele'ted .ro* e'( distri'tD e'( distri't got group sele'ted .ro* t(e (ig(lnds
nd not(er .ro* t(e lowlnds. 8(ese regions re representtive o. t(e rurl res o. t(e 'ounty.
2.' (ata )eneration
Nulittive dt ws generted .ro* t(e .ield study. Interviews nd group dis'ussions were used .or dt
'olle'tion. Se*i stru'tured interviews were used to get personl ''ounts .ro* prti'ipnts w(i'( ddressed t(e
pertinent issues o. t(e reser'( 9uestions on 'o**uni'tion '(llenges in 'ontrol o. 'ervi'l 'n'er. ;''ording
to +vle (&GGG! interviews llow people to 'onvey to ot(ers sitution .ro* t(eir own perspe'tive nd in t(eir
own words. 8(e interview s'(edules were se*i-stru'tured to llow t(e prti'ipnts t(e .reedo* to give s *u'(
in.or*tion s t(ey 'ould. Individul interviews were pre.erred >e'use t(ey would yield in-dept( dt. 1oy'e
(2006! .urt(er outlines t(e dvntges o. interviews w(i'( suit t(e purpose o. t(is reser'(. 1oy'e notes t(t in-
dept( interviews re used w(ere reser'( (s lredy >een done nd (s *esured 'ertin i*portnt 'on'ern%
nd t(roug( interviews *ore insig(t is e2plored s to w(y t(e sitution is t(e wy t(e *esure*ent ws dedu'ed.
8(ere re reser'( .indings done on t(e stte o. 'ervi'l 'n'er in generl in t(e world nd in individul
'ountries. Jigures given >y orgniBtions su'( s </#% I;0C nd +4,0I s(ow per'entges nd nu*>ers
re.le'ting t(e dire sitution o. t(e 'ervi'l 'n'er. 8(is 9ulittive reser'( goes into t(e dept( o. interrogting
w(y wo*en 'ontinue to su..er t(e rvges o. 'ervi'l 'n'er in silen'e. 1oy'e lso e2plins t(e vlue o.
interviews s giving n opportunity to prti'ipnts to llow s(ring o. lived e2perien'es .reely nd *ore
trut(.ully s *u'( s possi>le. During t(e individul interviews o. t(is study prti'ipnts nd reser'(er
engged t personl level nd *ost o. t(e* engged 9uite deeply >out t(e personl perspe'tive t(ey (old
>out t(e 'ervi'l 'n'er.
Dt 'olle'ted .ro* t(e JFDs ws on t(e generl wreness o. wo*en regrding 'ervi'l 'n'er. 8(e
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prti'ipnts were not ne'essrily 'ervi'l 'n'er ptients. ;n i*portnt 'o*ponent o. 'ervi'l 'n'er 'ontrol is
prevention nd one o. t(e reser'( 9uestions ddresses )nowledge levels o. wo*en regrding 'ervi'l 'n'er.
JFDs were i*ed t interrogting t(e 'o**uni'tion '(llenges rurl wo*en re .'ed wit( so t(t t(ey end up
not going .or s'reening or '(e') up erly enoug( to prevent pre'n'erous 'ells developing into .ull >lown 'n'er.
;''ording to ,orgn (&GG3! JFDs (ve dvntges w(en 'olle'ting reser'( in t(e .ollowing wysD t(ey 'n
produ'e vlu>le in.or*tion w(i'( personl interviews *y not yieldD one JFD *eeting 'uts on resour'es nd
yields s *u'( in.or*tionD responses 'n >e 'lri.ied nd e2pnded upon pro>ingD group *e*>ers re't nd
>uild on e'( ot(erIs responses 'onse9uently yielding in.or*tion t(ey *ig(t not (ve given individully. In
t(is reser'( on 'ervi'l 'n'er% nu*>er o. issues on *yt(s (eld >y t(e 'o**unity >out 'n'er were >roug(t
out nd t(is gve insig(t into so*e o. t(e '(llenges rurl wo*en .'e in 'o**uni'ting 'ervi'l 'n'er%
t(roug( t(e JFDs. During >ot( t(e interviews nd JFDs vi'rious understnding ws soug(t wit(out
?udg*ent. 8(is ws '(ieved s Ptton (2002! o>serves% >y s(owing openness% sensitivity% respe't% wreness
nd responsiveness.
2.* (ata Analysis
8(e dt gt(ered .ro* t(e .ield will >e nlyBed 9ulittively using dou>le (er*eneuti' nd t(e*ti' nlysis.
8(ese *et(ods will >e pre.erred >e'use t(ere will >e lot o. 9ulittive dt to >e (ndled nd t(e*ti'
nlysis in prti'ulr provides t(e ne'essry steps to >e .ollowed so s to .inlly 'o*e up wit( t(e ne'essry
t(e*ti' 'on'erns o. t(e study. Dou>le (er*eneuti' nlysis will >e used in t(is study >e'use t(e nture o.
p(eno*enologi'l reser'( is *ostly dilogi'l nd dis'ussions re lden wit( interprettion. ,ills% Durepos nd
<ie>e (20&0! dis'uss t(e ppli'tion o. dou>le (er*eneuti' s ppli'>le in t(e so'il s'ien'es. 8(ey 'ontend
t(t w(en designing so'il s'ien'e reser'( it is i*portnt to 'onsider t(t t(e pr*eters o. t(e reser'( 'onte2t
re not li*ited to t(e o>?e't o. t(e reser'(. In9uiry t(t ')nowledges t(e presen'e o. t(e dou>le (er*eneuti'
'n use re.le2ivity to >etter grpple wit( t(e inter'tions o. *ening-*)ing present >etween su>?e't nd o>?e't%
nd in >ot( t(e reser'( design nd in t(e interprettion o. dt.
;''ording to Fiddens (&G32! in using t(e dou>le (er*eneuti' to interpret te2ts one '(ieves w(t is )nown s
verste(en% t(e understnding o. *ening. $erste(en ws t)en to involve KrelievingI or Kre-e2perien'ingI t(e
*entl sttes i. t(ose w(ose 'tivities or 'retions re to >e interpreted. 8(is study will see) to unrvel t(e
e2perien'es o. t(e wo*en wit( 'ervi'l 'n'er nd t(e 'o**uni'tion '(llenges e2perien'ed. Fd*er% one o.
t(e erly proponents o. t(e dou>le (er*eneuti'% lo'tes t(e 'on'ept s9urely in lnguge s t(e *ediu* in w(i'(
KunderstndingI is .und*entl to (u*n li.e. 8(e pro'ess is dilogi'l >e'use w(t is generted eventully is
K*utul )nowledgeI >etween t(e reser'(er nd t(e prti'ipnts. In t(is study dou>le (er*eneuti' is used to
generte 'on'erns t(t will >e nlyBed t(e*ti'lly.
So*e o. t(e redings t(t will guide t(e*ti' nlysis .or t(is study re6 Hwn nd #ngondo (20&&!% +o*>o nd
8ro*p% (20&0!% 1run nd Clr)e (2005!% 8(o*s (2005!% E'ey nd Eu.. (200&!. In t(e*ti' nlysis t(e .o'us
is to go in-dept( in ssessing t(e 'on'erns t(t will (ve >een interpreted .ro* t(e study. ;ll units o. dt su'(
s words% senten'es% puses% nd >ody lnguge will >e e2tr'ted nd e2*ined in detil. 8(ere re nu*>er o.
stges t(t will >e .ollowed in t(e t(e*ti' nlysis s outlined >elow6
Transcription: tpe re'orded interviews nd JFDs will >e trns'ri>ed. Non ver>l 'ues will >e in'luded >e'use
t(ey too 'o**uni'te *ening.
Organising data: dt will >e orgniBed into esily retriev>le se'tions. <innowing will lso >e done >e'use
t(e dt will >e in lrge *ounts. 8(is will entil 'oding e'( interview nd o>servtion% >re)ing up .ield notes
into se'tions identi.ied >y dtes or 'onte2t. Interviewees will lso need to >e given pseudony*s or re.erred to >y
'ode nu*>er. Sensitive *teril t(t re9uires 'on.identility will >e (ndled 're.ully nd given ne'essry
nony*ityA Identi.i>le *teril will >e re*oved .ro* t(e trns'ripts.
Familiarization: t(is will >e done >y listening to tpes% reding nd re-reding dt% *)ing *e*o nd
su**ries >e.ore t(e .or*l nlysis >egins. J*iliriBtion will >e n i*portnt stge >e'use so*e dt *y
not (ve >een 'olle'ted >y t(e reser'(er >ut >y n ssistnt.
Coding: putting 'on'epts s 'odes under (edings will >e done. Developing t(e 'oding syste* will involve open
'oding% 2il 'oding% nd sele'tive 'oding. 8(e ulti*te gol in 'oding will >e to 'lssi.y *?or issues or topi's
e*nting .ro* t(e reser'( 9uestions.
Themes: t(e*es nd e*ergent 'on'epts will >e identi.ied nd re'orded into well de.ined 'tegories. 8(is will
led to developing nrrtive t(t 'onsolidtes t(e .inding in 'o(erent prose.
2.1+ #thical consideration
0eser'(ing on 'ervi'l 'n'er is sensitive undert)ing >e'use o. t(e privte nture o. t(e su>?e't s disese.
;s reser'(er t(ere ws need to o>serve ll et(i'l issues t(t *y >e re9uired in t(e pro'ess o. reser'(
(/**ersley% 2007!. #ne o. t(e et(i'l 'onsidertions is in.or*ed nd e2pressed 'onsent (+vle% &GG6!. <(ere
ptient (s to >e interviewed nd is not in position to *)e 'ler ?udg*ent o. issues% ne2t o. )in or
'regiver ws >e soug(t .or 'onsent. 8(e reser'( i*ed t voiding de'eption t ny stge. ;nony*ity ws
o>served. Silver*n (200G! notes to reser'(ers t(t t(e 'ore vlue in reser'( is not to e2pose person or
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institution >ut to 'olle't dt. ;voidn'e o. (r* ws lso o>served t(roug( 're.ul (ndling o. people nd
in.or*tion. Prti'ipnts did not get ny dire't py*entD (owever% .ter t(e interview session t(ere ws so*e
to)en o. ppre'ition o. o..ering .ew >oug(t ite*s. 8(e de'ision to give to)en o. ppre'ition ws re'(ed
.ter 'onsidering t(e .'t t(t t(e prti'ipnts (d s'ri.i'ed t(eir ti*e. #..i'il per*ission nd per*its were
o>tined .or purpose o. gining entry into 'o**unities nd institutions su'( s (ospitls .or ''ess to *terils
nd re.eren'es. 8(e pl'e o. t(e interviews nd JFDs ws s neutrl nd s 'o*.ort>le s possi>le .or >ot( t(e
prti'ipnts nd t(e reser'(er.

$! Met#odological C#allenges
i!. S*pling pro'edures% C(llenges o. ensuring t(t >is is voided in t(e use o. non pro>>ility s*pling
pro'edures% in t(is 'se purposive s*pling% snow>lling nd 9uot s*pling. Nuestion o. '(ieving
*2i*u* vrition 'n >e '(llenge.
ii!. Pro'ess o. dt genertion6 8(e 'tul pro'ess is .'ed wit( *ny unpre'edented eventulities su'( s
prti'ipnt '(oosing to dwell on issues t(t tend to go out o. t(e *in topi's o. t(e reser'( 9uestions. 8(e
di..i'ulty o. 'ontrolling t(e interview wit(out o..ending t(e prti'ipnts.
iii!. Dt nlysis6 8(e*ti' nlysis involves deling wit( lot o. dt nd orgniBing it into *ening.ul
t(e*es 'n >e '(llenging. 8(e use o. dou>le (er*eneuti' to interpret t(e .indings so*eti*es poses t(e
'(llenge o. (ow .r one s(ould interpret *ening *de >y not(er person in t(e dilogi'l pro'ess.
iv!. ,e*>er '(e')ing o.ten ppered li)e trp w(ere t(ere is .er o. prti'ipnts res'inding on t(eir stte*ent%
nd so*eti*es t(e stte*ent ppered s i*portnt to t(e reser'(.
v!. 42pe'ttion o. t(e pnel versus w(t one wnts to '(ieve s 9ulittive reser'(er .or e2*ple6
vi!. S*ll s*ple versus t(e trditionl e2pe'ttion in 9untittive studies to use lrge s*ple
vii!. 8(e use o. reser'( 9uestions only (no o>?e'tives!
viii!. Identi.ying wit( t(e prti'ipnts nd >lending into t(eir dily 'tivities s e2pe'ted o. nturlisti' in9uiry
>rings 9uestion o. possi>ility >is.

&! Emerging issues from findings of t#e study
i!. E') o. de9ute in.or*tion% t(e prti'ipnts >ot( in individul interviews nd JFDS >roug(t out t(e
issues o. l') o. wreness >out 'ervi'l 'n'er nd t(e .our 'o*ponents o. 'n'er 'ontrol6 dete'tion%
prevention% tret*ent nd pllitive 're. ;ny 'o**uni'tion t(e wo*en ''ess is s'nty nd t(ere.ore
leding to l') o. ny 'tion on t(eir prt .or e2*ple% w(en nd w(ere to go .or s'reening.
ii!. ,yt(s surrounding 'n'er. 8(is '*e out s *?or '(llenge in 'o**uni'ting 'ervi'l 'n'er issues
*ong rurl wo*en. 8(ere re *yt(s t(t *)e t(e* not tl) >out t(e disese s t(ey ll 'entre on
ulti*te det(. 8(e n*es given to 'n'er su'( s evil oneD t(e K>d oneI t(e person is KspoiltI nd even
totl l') o. n*e Kt(t oneI.
iii!. Jer is lso n issue lin)ed to *yt(s >out 'n'er. 8(e wo*en e2pressed generl .er o. >eing s'reened or
going t(roug( 'ertin tret*ent pro'esses. S'reening instilled .er o. t(e possi>ility o. >eing dignosed wit(
'n'er. Jor t(ose see)ing tret*ent t(ere ws .er o. going .or surgi'l pro'edures 'li*ing t(t nyone
t(ey )new w(o went .or surgery did not 'o*e >') (o*e live.
iv!. Stig* e*erges lso s 'ontri>utor to '(llenges o. 'o**uni'tion. 4*>rrss*ent .ro* l') o.
understnding 'ervi'l 'n'er w(i'( leds to it >eing sso'ited wit( se2ul diseses% *)es *ny wo*en
to s(y wy .ro* dis'ussing t(e illness. Cervi'l 'n'er is lso stig*tiBed >e'use o. its lo'tion in t(e
(u*n >ody. 8(ereIs 'on.usion or l') o. understnding (en'e >eing sso'ited wit( i**orlity
v!. Culture. 0url 'o**unities su>s'ri>e to vrious 'ulturl >elie.s nd t(is (s e*erged s one o. t(e resons
t(e wo*en .ind it di..i'ult to dis'uss 'ervi'l 'n'er. 0eprodu'tive (elt( is relegted >e'use 'ulture does
not per*it dis'ussion o. *tters t(t tou'( on t(e reprodu'tive syste* o. person% *ore so o. wo*en% l')
o. n*es .or spe'i.i' >ody prts nd orgns% *enstrution@>leeding.
vi!. 8>oo lso 'onstitutes '(llenge in 'o**uni'ting 'ervi'l 'n'er. 8(e prti'ipnts >ring out t(e .'t t(t
'n'er is no *ention disese. 8(e (us(ed tone o. t(e JFDs prti'ipnts >ring t(is out. Foing .or
s'reening is voided >e'use (elt(y wo*n 'nnot e2pose (er privte >ody to nyone% >e'use it is
t>oo.
vii!. E') o. support t *edi'l .'ilities. 8(e ptients e2pressed dis'o*.ort% l') o. support% nd generl
ppre(ension in (ow so*e *edi'l st.. (ndles t(e*. 8(ere.ore t(ey void going >') to 'ertin (elt(
.'ilities% espe'illy t(e lo'l (ospitls.
viii!. 0ole o. *le prtner or (ed o. t(e (ouse(old. It e*erged t(e wo*en generlly needed t(e support or
per*ission o. t(e *le prtner in order to ddress issue o. s'reening nd tret*ent. 8(is is seen in (ow t(e
(us>nds nd *le reltives e2press dis'ourge*ent to t(e wo*en .or l') o. understnding t(e .'tors
surrounding 'n'er 'ontrol. ,ost o. t(e prti'ipnts 'li*ed t(eir ppre(ensive spouses dis'ourged t(e*
.ro* going .or s'reening.
Developing Country Studies www.iiste.org
ISSN 2224-607X (Pper! ISSN 222"-0"6" (#nline!
$ol.4% No.&"% 20&4

3
i2!. 8(e *edi is not .ully utiliBed to '*pign .or 'n'er wreness. 8(is is s(own >y (ow t(e prti'ipnts
'li* t(ey (ve (erd very little i. ny in.or*tion on *edi >out 'n'er despite t(e presen'e o. vrious
lo'l J, rdio sttions nd television '(nnels.
2!. 8(e lnguge o. 'o**uni'tion >etween rurl wo*en nd *edi'l personnel is '(llenge. 8(e
prti'ipnts o.ten tl)ed o. >eing :told t(ings in t(t lnguge o. yours= (*ening 4nglis(!. 8(e rurl
wo*en do not .eel prt o. t(e pro'ess.
2i!. 8(e point (2! >ove leds to t(e issue o. prti'iptory 'o**uni'tion. Jro* t(e .indings it e*erged t(t
rurl wo*en desire to >e involved in 'o**uni'tion pro'esses in '*pigns >out 'ervi'l 'n'er. 8(e
JFDs >roug(t out lot o. interest in t(e wo*en prti'ipnts nd t(ey opened up giving suggestions on (ow
e..e'tive '*pigns 'n >e done on t(e ground.
2ii!. 8(e need to >lend indigenous )nowledge nd *odern *edi'ine e*erged. 8(ere ws pprent 'on.usion
*ong *ost 'ervi'l 'n'er ptient prti'ipnts s t(ey e2plined (ow t(ey soug(t tret*entD so*eti*es
t(ey (d 'on.li'ting in.or*tion nd t(ere.ore (esitted to tell one prty w(t t(ey (d e2perien'ed in t(e
ot(er institution. 8(t is% i. t(ey soug(t trditionl tret*ent% t(ey did not dis'lose to t(e *edi'l do'tor nd
t(e 'se ws t(e s*e vi'e vers.

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ISSN 2224-607X (Pper! ISSN 222"-0"6" (#nline!
$ol.4% No.&"% 20&4

G
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