Abstract / Summary
Abstract Background Cervical cancer remains a major public health concern in sub-Saharan Africa, with disproportionately high morbidity and mortality in low-resource settings. Although effective preventive strategies such as cervical cancer screening and human papillomavirus (HPV) vaccination exist, uptake remains suboptimal in rural Nigerian communities. This study assessed awareness of cervical cancer screening modalities and barriers to HPV vaccination among women in rural Ebonyi State, Nigeria. Methods A multicenter descriptive cross-sectional study was conducted among 683 women aged 18 years and above during rural health outreach programs in Ebonyi State, southeastern Nigeria. Data were collected using structured interviewer-administered questionnaires capturing socio-demographic characteristics, reproductive history, awareness of cervical cancer screening modalities, HPV vaccination status, and barriers to vaccination. Data were analyzed using descriptive statistics. Results The mean age of respondents was 42.23 ± 10.73 years. Most participants were married (89.6%), multiparous or grand multiparous (90.2%), and had at least secondary education (60.7%). Only 17.1% were aware of cervical cancer screening modalities. HPV vaccine uptake was low, with 3.1% reporting receipt of the vaccine and 7.6% reporting vaccination of their daughters. Access-related barriers were the predominant reason for non-vaccination (71.3% for self; 76.0% for daughters), followed by lack of awareness and knowledge (24.9%). Conclusion Awareness of cervical cancer screening modalities and HPV vaccination remains low among women in rural Ebonyi State. HPV vaccine uptake is critically inadequate, largely due to structural access barriers. Strengthening rural health systems, decentralizing vaccine delivery, and enhancing community-based education are essential to advancing equitable cervical cancer prevention efforts in Nigeria.