Socioeconomic inequality in cervical cancer screening uptake among women in sub-Saharan Africa: a decomposition analysis of Demographic and Health Survey data

Abstract

ObjectiveTo examine socioeconomic inequalities in the use of cervical cancer screening among women in sub-Saharan Africa.DesignSecondary data from the Demographic and Health Survey data in sub-Saharan Africa.SettingSub-Saharan Africa.ParticipantsWomen aged 15–64 years.Outcome measuresSocioeconomic inequalities in cervical cancer screening uptake and the pooled prevalence of cervical cancer screening.ResultsThe pooled prevalence of cervical cancer screening among women in sub-Saharan African countries was 10.51% (95% CI: 7.54% to 13.48%). Cervical cancer screening uptake showed a significant pro-rich distribution of wealth-related inequalities, with a weighted Erreygers normalised concentration index of 0.084 and an SE of 0.003 (p value <0.0001). This finding suggests that disparities in cervical cancer screening uptake among women are related to wealth. Decomposition analysis revealed that the wealth index, educational status, place of residence and media exposure were the most important factors contributing to this pro-rich socioeconomic inequality in cervical cancer screening.ConclusionThis study emphasises the importance of addressing modifiable factors such as improving educational opportunities, increasing media exposure accessibility in households and improving the country’s economy to reduce wealth disparities and improve cervical cancer screening uptake among women.