The study found that Women’s marital status, residence, occupation, distance to primary health care facility, health workers encouragement, frequency of health facility visits, birth experience, place of birth, awareness about cervical cancer and cervical cancer screening service were the predictive variables of reproductive age women’s uptake of the cervical cancer screening in the study area.

According to this study, the uptake of cervical cancer screening service was 38.7%. This was higher than the finding of studies conducted in Addis Ababa (25%), Amhara region (5%), Hossana town (14.2%), St. Paul’s Teaching and Referral Hospital (12.2%), southern Ethiopia (27.7%), Wolaita Zone (22.9%), Yirgalem hospital (16.5%), Kenya (25.6%), and Zimbabwe (83.2%) [17,18,19,20,21,22,23,24,25]. The finding of this study revealed promising practice of the cervical cancer screening service among aged 15 years or more compared to the previous study findings [17,18,19,20,21,22,23,24]. This might be due to SBCC activities and cervical cancer screening campaigns conducted in the study area, which implicates the significance of conducting SBCC intervention and provision of CCa screening campaigns to increase the uptake. In addition, geographical and time difference played key roles on this study as it was conducted in rural and community-based setting unlike the previous studies that were conducted in urban institutional settings.

Women who live in urban area were 4.45 times more likely to receive cervical cancer screening service than study participants who live in rural area (AOR = 4.45, 95%CI = 2.85–6.96). This finding was supported by a study conducted at St. Paul’s Teaching and Referral Hospital [20]. This indicated that majority of health facilities that provide CCa screening were found at urban settings. In addition, urban dwellers might have more information about it through different medias/means. Furthermore, populations found at urban settings might have better educational background than women living in rural setting. This is revealed in the study that women who attended secondary and above education level were 1.95 times more likely to actively uptake cervical cancer screening service than those who had not attended formal education (AOR = 1.95, 95% CI = 1.12–3.49). This result is consistent with the findings of studies conducted at different settings in Ethiopia [18, 21, 22]. These findings imply that there is a need to empower women regardless of their residency through formal education and also conducting social and behavioral change communication interventions. In addition, there is a need to expand health facilities to the rural settings to equitably reach all women.

Married women were 10.74 times more likely to participate in the cervical cancer screening service than unmarried women (AOR = 10.74, 95% CI = 5.02–22.96), according to this study. This finding is in contrast to the finding of studies conducted in different settings, which revealed that married women were less likely to involve in the cervical cancer screening service delivery.

[18, 22]. The difference might be attributed to the geographical and cultural differences in the study areas and the impact of SBCC interventions and cervical cancer screening campaigns on the current study.

This study revealed that birth experience and place of birth were predictors of the uptake of cervical cancer screening service among women aged 15 years old or more. Women who had a birth experience were 8.92 times more likely to receive cervical cancer screening service than women who study participants who have no childbirth experience (AOR = 8.92, 95% CI = 4.28–19.19). This might imply that those women who had a history of birth experience might have better interaction or communication with the health workers during their visit. On the other hand, it might indicate that women had visited health facilities have an opportunity to gain awareness about the cervical cancer screening service uptake, which leads to better utilization of the screening service. Women who gave birth at the health facilities (health center, hospital, health post and private clinics) had higher uptake of cervical cancer screening than those who gave birth at home.

Women who had one or more visit of health facilities per year for any health problems were 3.63 times (AOR = 3.63, 95% CI = 1.86–6.93) more likely to receive cervical cancer screening services from health facilities compared to those women with no history of health facility visits. This finding was supported by the reports of studies conducted at Peru and Kenya [26, 27]. This finding might indicated that while women visited health facilities, they would get adequate information about it or encouraged by health facilities. This study revealed that health workers encouragement as one of the predicting factors identified. Those women encouraged by health workers to use cervical cancer screening services were 3.23 times more likely to utilize the service from health settings than women of reproductive age who had not been visited by community health workers (AOR = 3.23, 95% CI = 1.57–6.63). The finding of this study was supported by the result of a study conducted in Jordan which showed that health workers encouragement improved the cervical cancer screening service uptake [28].

Women of reproductive age who gave birth at the health facilities and had a history of visiting health facilities have better record of cervical cancer screening service utilization. These might indicate that they the health workers provided awareness and encouraged women to uptake the cervical cancer screening service. The study also found that women who had awareness about cervical cancer and cervical cancer screening were 0.37 and 4.52 times more likely to uptake cervical cancer screening services. This finding was supported by the findings of studies conducted in different parts of Ethiopia [17, 18, 20, 22].

Women who were employed in government organizations were 2.61 times more likely to uptake cervical cancer screening service (AOR = 2.61, 95% CI = 1.33–5.15), according to the finding of this study. This report is in agreement with the finding of a study conducted at Jimma [29]. Perceived distance from the screening health facility was one of the perceived predictor for the uptake of cervical cancer screening service reported from the participants of this study. Women aged 15 years or older who have the access to and availability of health facility for receiving cervical cancer screening service were 4.45 times more likely to actively screen for cervical cancer check-ups than study participants who travels longer distance to health facility (AOR = 4.41,95%CI = 2.53–9.41). This finding was supported by the finding of a study conducted in Zimbabwe [30], which showed that long distance from health facilities at which cervical cancer screening was conducted was one of a barrier for poor utilization of the cervical cancer screening service.

Generally, the findings highlights that there is a need to empower women through education and decision making; designing and providing health education program to raise consciousness of women at the health facilities regularly; and, conducting social and behavioral change communication interventions.