Factors determining who receives cervical screening in South Africa

A new study on determinants of cervical screening from South Africa, based on a representative sample of 2789 women from the 2016 South African Demographic and Health Survey, was co-authored by International Centre for Future Health Systems Adjunct Associate Professor Freddy Sitas. Being tested for HIV, being wealthy, of non-Black ethnicity and more educated, were the most important determinants of cervical screening uptake. The overall screening rate of 42% and the strong association with HIV testing suggests that screening often occurs opportunistically.

African women having lower cervical cancer screening uptake is consistent with international experience. These disparities highlight the need to improve screening uptake for cervical cancer by expanding the health workforce, implementing task shifting, and training community health workers to organise and mobilize communities for outreach services. The authors argue future health systems would improve uptake by embracing equity focused approaches by implementing screening where people are. Evidence shows this can be achieved for example, by having mobile clinics in the workplace, in communities, and operating over weekends. Furthermore, implementing culturally focused educational initiatives (e.g.in local languages) to enhance public awareness of the importance of cervical cancer screening is another crucial strategy for tackling this public health challenge.