Document Type
Journal Article
Publication Date
1-1-2015
Journal
BMC Public Health
Volume
15
Issue
1
Inclusive Pages
382
DOI
10.1186/s12889-015-1686-5
Keywords
Early Detection of Cancer--statistics & numerical data; Health Services Accessibility--statistics & numerical data; Uterine Cervical Neoplasms--prevention & control
Abstract
Background
Cervical cancer is the most commonly diagnosed cancer and the leading cause of cancer mortality among women in sub-Saharan Africa. Recent recommendations for cervical cancer primary prevention highlight HPV vaccination, and secondary prevention through screening. However, few studies have examined the different dimensions of health care access, and how these may influence screening behavior, especially in the context of clinical preventive services.
Methods
Using the 2003 South Africa World Health Survey, we determined the prevalence of cervical cancer screening with pelvic examinations and/or pap smears among women ages 18 years and older. We also examined the association between multiple dimensions of health care access and screening focusing on the affordability, availability, accessibility, accommodation and acceptability components.
Results
About 1 in 4 (25.3%, n = 65) of the women who attended a health care facility in the past year got screened for cervical cancer. Screened women had a significantly higher number of health care providers available compared with unscreened women (mean 125 vs.12, p-value
Conclusions
Our findings suggest that cost issues (affordability component) and other patient level factors (captured in the acceptability, accessibility and accommodation components) were less important predictors of screening compared with availability of physicians in this population. Meeting cervical cancer screening and HPV vaccination goals will require significant investments in the health care workforce, improving health care worker density in poor and rural areas, and improved training of the existing workforce.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
APA Citation
Akinyemiju, T.F., McDonald, J.A., Lantz, P.M. (2015) Health care access dimensions and cervical cancer screening in South Africa: analysis of the world health survey. BMC Public Health 15(1): 382.
Peer Reviewed
1
Open Access
1
Comments
Reproduced with permission of BioMed Central. BMC Public Health.