Wealth-related inequalities of women’s knowledge of cervical cancer screening and service utilisation in 18 resource-constrained countries: evidence from a pooled decomposition analysis

Abstract

Introduction: Resource-constrained countries (RCCs) have the highest burden of cervical cancer (CC) in the world. Nonetheless, although CC can be prevented through screening for precancerous lesions, only a small proportion of women utilise screening services in RCCs. The objective of this study was to examine the magnitude of inequalities of women's knowledge and utilisation of cervical cancer screening (CCS) services in RCCs. Methods: A total of 1,802,413 sample observations from 18 RCC's latest national-level Demographic and Health Surveys (2008 to 2017-18) were analysed to assess wealth-related inequalities in terms of women's knowledge and utilisation of CCS services. Regression-based decomposition analyses were applied in order to compute the contribution to the inequality disparities of the explanatory variables for women's knowledge and utilisation of CCS services.

Uptake and Correlates of Cervical and Breast Cancer Screening Among Women in Jordan: National Results of the 2017-2018 Population and Family Health Survey

“…In another study in Jordan that investigated the "public use of different media and channels for seeking health/cancer-related information," health service providers and TV were found the most trusted sources and may therefore be effective tools for health education (Akhu-Zaheya et al, 2014). Unlike some previous studies, including in Jordan (Al Rifai & Nakamura, 2015;Mahumud et al, 2020;Phaswana-Mafuya & Peltzer, 2018;Tiruneh et al, 2017), this study did not show that having a health insurance and urban residence increased the odds for cancer screening.…”

“…In this 2017-2018 national population-based survey among women (15-49 years) in Jordan, the prevalence of ever CCS (15.3%) was lower than in the 2012 national survey in Jordan (18.8%, women 15-49 years) (Al Rifai & Nakamura, 2015), a local survey in Amman, Jordan (31.2%, 21-65 years) (Al-Amro et al, 2020) and another local survey in Jordan (38%, 18-63 years) (Asali et al, 2020). The CCS prevalence rate in Jordan was also lower than the national Demographic and Health Surveys in 18 countries (29.2%) (Mahumud et al, 2020), Egypt (97.4%) (Mahumud et al, 2020), Turkey (22.0%, 30 years and older) (Sözmen et al, 2016) and India (27.2%) (Mahumud et al, 2020). The prevalence of past 12-month CBE (13.9%) in this study was lower than in the 2012 Jordan national survey (19.3%) (Al Rifai & Nakamura, 2015) and in Brunei Darussalam STEPS survey (ever 56.2%, 18-69 years) (Pg Suhaimi et al, 2020).…”

“…Moreover, in a national survey among women (20-49 years) in Jordan in 2012, the prevalence of clinical breast examination in the past 12 months was 19.3% and lifetime Pap-smear testing 25.5% (Al Rifai & Nakamura, 2015), and in a national survey (N=1549) in 2011 in Jordan among women (≥18 years), 7% had ever undergone mammography (Othman et al, 2015). As part of the national Demographic and Health Surveys in 18 countries (women 15-49 years) the prevalence of the utilization of cervical cancer screening was 29.2%, (Mahumud et al, 2020), including in Egypt (97.4%), and India (27.2%) (Mahumud, et al, 2020), and in Turkey 22.0% (Sözmen et al, 2016). In women 30 years and older in Turkey 19.0% ever had a mammography (Sözmen et al, 2016) and in South Africa 13.4% ever had mammography (Phaswana & Peltzer, 2018).…”

“…In addition, having a health insurance (Mahumud et al, 2020;Tiruneh et al, 2017), media exposure (Al Rifai & Nakamura, 2015;Mahumud et al, 2020), sexual autonomy (Tiruneh et al, 2017), tobacco use (Al Rifai & Nakamura, 2015), living in the central and nothern region in Jordan (Al Rifai & Nakamura, 2015) were associated with clinical breast examination and/or cervical cancer screening. This study aimed to determine the prevalence and correlates of cervical and breast cancer screening in a national survey in Jordan in 2017-2018.…”

The Prevalence and Associated Factors of Cancer Screening Uptake Among a National Population-Based Sample of Adults in Marshall Islands

“…As part of the national Demographic and Health Surveys in 18 countries (women 21-49 years), the prevalence of the utilization of ever cervical cancer screening was 29.2% in 18 countries, 6 in India 27.2%, 6 in Tajikistan 10.6%, 6 and in Turkey ever cervical cancer screening (women 30 years and older) 22.0%. 7 In an analysis of nationally representative household surveys in 55 low- and middle-income countries, the country level median of lifetime cervical cancer screening among women aged 30-49 years 43.6%.…”