Involving men in communication to increase cervical cancer screening in rural Uganda

Abstract Cervical cancer incidence and mortality are much higher in low- and middle-income countries, reflecting major inequities driven by limited access to health services and socio-economic determinants. This qualitative study complements quantitative findings by exploring socio-cultural norms, attitudes, motivations, and behaviours of men in rural Uganda related to sexual and reproductive health decision-making. Insights aim to inform targeted communication strategies to enhance men's support for women's participation in cervical cancer prevention and screening programmes. We conducted 24 semi-structured interviews with husbands and community health workers, and two focus group discussions. Participants were purposively selected with the support of a local NGO from five subcounties in Kakumiro District. Interviews were conducted in local languages, translated, and transcribed into English. Data were analysed thematically using a code and retrieve approach. Most men identified as main decision-makers, though joint decision-making was also reported. In disagreements, men retained final authority, expecting wives to seek permission for screening. Men trusted family members and community leaders more than mass media. Radio was the most trusted medium and social media is scarcely used. Community health workers were highly trusted for health education and community mobilisation. Trust in western medicine was high, but myths and misconceptions are still and important barrier. Engaging men as active partners is essential. Men showed willingness to support and mobilize peers, and interventions must emphasize their role in facilitating their wives’ participation in screening programs. Sensitization strategies must address not only individual beliefs but also broader family and community dynamics. Strengthening community health workers is key to overcoming socio-cultural and logistical barriers to cervical cancer screening. Key messages • Engaging men and strengthening community health workers are crucial to overcoming barriers and increasing cervical cancer screening in rural Uganda. • Addressing male decision-making, trust sources, and community dynamics can significantly improve women's access to cervical cancer prevention services.