Investigating the disparities in cervical cancer screening among Namibian women

Kangmennaang, Joseph; Thogarapalli, Nandini; Mkandawire, Paul; Luginaah, Isaac

doi:10.1016/j.ygyno.2015.05.036

Cited by 25 publications

(22 citation statements)

References 25 publications

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“…The effect of health insurance on testing for prostate cancer remained robust even after controlling for access to information and socioeconomic and demographic factors, suggesting the disproportionate influence that having insurance coverage might have on an individual's access to cancer screening. This particular finding is generally consistent with the literature on the effect of insurance coverage on health utilisation in different places [ 10 , 31 , 35 ]. One key explanation might be that in Namibia health insurance coverage has a significant potential to reduce out-of-pocket health expenses, increase the frequency of hospital visits and quality of interacting with doctors, and reduce payment for health care at the point of service, including screening for prostate cancer.…”

Section: Discussionsupporting

confidence: 92%

“…Factors such as inadequate public health infrastructure and other health concerns such as HIV/AIDS and malaria compete for scarce health resources and likely undermine the provision of prostate cancer services. These challenges have similarly been observed in cervical cancer screening in Namibia [ 31 ] and in other regions such as South Africa [ 4 ]. For example, it has been suggested that factors that contribute to the low levels of screening largely stem from differences in health care access, lack of knowledge and information, and unavailability of early detection services [ 4 , 32 , 33 ].…”

Section: Introductionmentioning

confidence: 72%

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What Prevents Men Aged 40–64 Years from Prostate Cancer Screening in Namibia?

Kangmennaang

Mkandawire²,

Luginaah

2016

Journal of Cancer Epidemiology

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Objectives. Although a growing body of evidence demonstrates the public health burden of prostate cancer in SSA, relatively little is known about the underlying factors surrounding the low levels of testing for the disease in the context of this region. Using Namibia Demographic Health Survey dataset (NDHS, 2013), we examined the factors that influence men's decision to screen for prostate cancer in Namibia. Methods. We use complementary log-log regression models to explore the determinants of screening for prostate cancer. We also corrected for the effect of unobserved heterogeneity that may affect screening behaviours at the cluster level. Results. The results show that health insurance coverage (OR = 2.95, p = 0.01) is an important predictor of screening for prostate cancer in Namibia. In addition, higher education and discussing reproductive issues with a health worker (OR = 2.02, p = 0.05) were more likely to screening for prostate cancer. Conclusions. A universal health insurance scheme may be necessary to increase uptake of prostate cancer screening. However it needs to be acknowledged that expanded screening can have negative consequences and any allocation of scarce resources towards screening must be guided by evidence obtained from the local context about the costs and benefits of screening.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 72%

What Prevents Men Aged 40–64 Years from Prostate Cancer Screening in Namibia?

Kangmennaang

Mkandawire²,

Luginaah

2016

Journal of Cancer Epidemiology

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“…The low patronage for cervical cancer screening using Pap smear has been reported in previous publications in Ghana [2][3][4]15]. This low patronage for cervical cancer screening is not peculiar to Ghana but has been reported in other developing countries [8,20,24]. In India, the country with the largest burden of cervical cancer worldwide, patronage was only 11.6% among nurses (health workers who are expected to know and have the right attitude towards screening for cervical cancer) [27].…”

Section: Discussionmentioning

confidence: 77%

Cervical cancer screening practices among women in Ghana: evidence from wave 2 of the WHO study on global AGEing and adult health

et al. 2020

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Background: Cervical cancer is the third most common cancer that affects women worldwide. It has been and remains the leading cause of cancer mortality among women in Ghana. Despite the fact that cervical cancer is preventable through early detection and treatment of precancerous lesions, anecdotal evidence from gynaecological clinics in Ghana indicates that most patients present with a late stage of the disease. This study assesses the cervical cancer screening practices among women in Ghana. Methods: Data from the World Health Organization's (WHO) multi-country Study on AGEing and adult health (SAGE) wave 2 conducted between 2014 and 2015 in Ghana was used. We employed binary logistic regression models to analyse data on 2711 women to examine factors associated with having pelvic examination among women aged ≥18 years. Among those who had pelvic examination, we applied binary logistic regression models to analyse factors associated with receiving Pap smear test as a subgroup analysis. Results: Of the 2711 women aged 18 years or older surveyed, 225 (8.3%) had ever had a pelvic examination and only 66 (2.4%) of them reported ever having done a Pap smear test. For those who had pelvic examination, only 26.94% had Pap smear test. Ethnic group, marital status, father's educational level and difficulty with self-care were independently associated with undergoing pelvic examination. Only age and healthcare involvement were independently associated with pelvic examination within the past 5 years to the survey. Marital status, satisfaction with healthcare and healthcare involvement were independently associated with Pap smear test. Conclusion: Even though cervical cancer is preventable through early detection of precancerous lesions using Pap smear test, the patronage of this screening test is still very low in Ghana. Factors influencing the low patronage in Ghana include the marital status of women, their level of satisfaction with healthcare as well as their level of involvement with healthcare. These may be the consequences of a weak health system and the lack of a national policy on cervical cancer screening.

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“…A growing number of studies have examined factors affecting health screening in developed countries . However, this issue is relatively under‐researched for Malaysia.…”

Section: Introductionmentioning

confidence: 99%

“…A growing number of studies have examined factors affecting health screening in developed countries. [8][9][10][11][12][13] However, this issue is relatively under-researched for Malaysia. Although Dunn and Tan 14,15 used nationwide data to analyze the factors associated with health screening in Malaysia, their studies were limited to cervical and breast cancer examinations.…”

Section: Introductionmentioning

confidence: 99%