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Health Care Access and Sociodemographic Determinants of Cervical Cancer Screening in Zimbabwe: Analysis of the Demographic and Health Survey (306589)

John Fu, Saint Louis University 
Asabe Garba, Saint Louis University College for Public Health and Social Justice 
Ucheoma Nwaozuru, Saint Louis University College for Public Health and Social Justice 
Stephen Scroggins, Saint Louis University 
Anne Sebert Kuhlmann, Saint Louis University College for Public Health and Social Justice 
*Thembekile Shato, Saint Louis University College for Public Health and Social Justice 

Keywords: Cervical cancer, pap test, health care access, sub-Saharan Africa

This study examined the association between cervical cancer screening (pap smear) and healthcare access factors (distance to health facility; cost of service; needing permission; not wanting to go alone) in Zimbabwe. Women were asked whether each factor was a big problem or not in seeking care. We used the 2015 Zimbabwe Demographic Health Survey and data were analyzed using multiple logistic regression, controlling for covariates. Among 7,889 women aged 15-49 who knew about cervical cancer, 16% had ever had a pap smear. Cervical cancer screening was significantly associated with distance to health facility (OR:0.51,CI:0.43-0.61); cost of service (OR:0.73,CI:0.63-0.85); not wanting to go alone (OR:0.77,CI:0.60-0.99) and composite-access factor (OR: 0.62,CI:0.54-0.72). After controlling for covariates including wealth index, location and health insurance, there was no association between access factors and screening. In conclusion, uptake of cervical cancer screening in Zimbabwe is very low. Enhancing prevention, to reduce cervical cancer burden, may require complimentary approaches tackling both specific healthcare access and socio-economic determinants.