Barriers to utilisation of cervical cancer screening in Sub Sahara Africa: a systematic review

Background Cervical cancer is the commonest cause of cancer‐related death in Sub Sahara Africa (SSA). Both primary and secondary preventive services are available but utilisation remain low. This systematic review aims to summarise reported barriers preventing women from utilising cervical cancer sc...

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Veröffentlicht in:European journal of cancer care Jg. 26; H. 1; S. e12444 - n/a
Hauptverfasser: Lim, J.N.W., Ojo, A.A.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England John Wiley & Sons, Inc 01.01.2017
Schlagworte:
Africa South of the Sahara
Attitude of Health Personnel
barriers
Cervical cancer
cervical cancer screening
Communication Barriers
Costs and Cost Analysis
Culture
Early Detection of Cancer - statistics & numerical data
Fear
Female
Health Knowledge, Attitudes, Practice
Health Services Accessibility
Household Work
Human papillomavirus
Humans
Interpersonal Relations
Medical screening
Patient Acceptance of Health Care - psychology
Patient Education as Topic
Self Concept
Shame
Spouses - psychology
Stereotyping
Sub Sahara Africa
systematic review
Uterine Cervical Neoplasms - prevention & control
Uterine Cervical Neoplasms - psychology
Womens health
Africa South of the Sahara
cervical cancer screening
Sub Sahara Africa
barriers
systematic review
ISSN:0961-5423, 1365-2354, 1365-2354
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Zusammenfassung:Background Cervical cancer is the commonest cause of cancer‐related death in Sub Sahara Africa (SSA). Both primary and secondary preventive services are available but utilisation remain low. This systematic review aims to summarise reported barriers preventing women from utilising cervical cancer screening services in SSA. Method Electronic searches on MEDLINE, EMBASE, PsycINFO, BIOSIS preview, Global Health, PubMed, Cochrane library, CINAHL, ISI Web of Knowledge and Google scholar and quality assessment of the included studies were performed. A meta‐analysis was applied to identify major themes. Results Eight studies exploring reasons women did not utilise cervical cancer screening were included. Women in SSA reported similar barriers despite cultural and language diversity in the region. Women reported fear of screening procedure and negative outcome, low level of awareness of services, embarrassment and possible violation of privacy, lack of spousal support, societal stigmatisation, cost of accessing services and health service factors like proximity to facility, facility navigation, waiting time and health care personnel attitude. Conclusion Strategies for improving uptake and utilisation of cervical screening in SSA should focus on improving cervical health education, addressing cultural beliefs and practices and improving spousal support and empowering women, as well as addressing physical access problem, costs and improving staff attitude.
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ISSN:0961-5423
1365-2354
1365-2354
DOI:10.1111/ecc.12444