Migrant women’s knowledge and perceived sociocultural barriers to cervical cancer screening programme: a qualitative study of African women in Poland

Abstract

This article explores both the knowledge and perception of African women about the importance of screening as a recommended health action to counter the growing rate of cervical cancer in women. The theoretical framework is influenced by the postulations of behavioural theories, sociology of health and the health belief model (HBM) on how people perceive health issues such as cervical cancer and its screening measures. In addition, this study tries to explore the acculturation challenges involved in migration, which adversely affects health knowledge and behaviour of African women. To achieve this, one focus group discussion was conducted with twelve women between the ages of 25 and 54 years old from Egypt, Eritrea, Kenya and Nigeria to share their knowledge of cervical cancer screening programmes in Poland. They constituted a mixture of women from different parts of Africa with cultural differences and different belief systems. Little or no in-depth understanding of Polish language, lack of information about the disease and its screening methods, lack of understanding of the Polish health care systems and social economic factors were issues discussed by these women as socio-cultural barriers to their non-participation in the organised cervical cancer screening programme in Poland. Based on this study, migrant women lack adequate information about cervical cancer, its causes, risk factors and its screening methods. Therefore, this study proposes that good understanding of health care systems, language translation support in the health care system, health awareness campaigns and social relationships are important motivating factors that could encourage migrant women to participate in the cancer screening programmes in Poland.

Factors associated with cervical cancer screening participation among migrant women in Europe: a scoping review

“…Indeed, having social support, either by the partner or husband, or even by family or friends has been showed to have positive impact on CCS participation [42]. Lack of social support was linked to postponing or avoiding screening [44,53]. Lower education has been negatively associated with CCS participation [47,48], as well as being unemployed [48,51,54] and having a low income [49,54].…”

“…Migrant woment that were invited to an organized CCS in Norway by an invitation letter perceived it as impersonal [42]. Long waiting times, for both the exams and the results, also leads women to postpone cervical screening [39,42,44]. Eastern European women (Polish, Slovak, and Romanian) in a English study referred poor hygiene in healthcare services as a barrier to participation in screening in England [39].…”

“…A large number of women did not want to know if they had cancer, and therefore they decided to not take the test [37,39,41,42,50]. Other psychological and emotional barriers included shyness, embarrassment, defenselessness, and discomfort for exposing their body [39,[41][42][43][44]50]. Emotional responses can also show up as fatalistic views about cancer, believing that it cannot be prevented nor cured and therefore it would be pointless to do the screening test [41].…”

“…Other migration-related factors with a negative impact on CCS participation include older age at migration [12], not being the first time a woman migrates (re-immigration) [54]. Also, some women showed preference to attend CCS in their home countries [39,44].…”

“…Also, women frequently state that they do not need CCS in the absence of symptoms, showing a low risk perception of the disease [27,37,42,50]. In the included studies, women expressed a wide range of knowledge about cervical cancer and cancer screening [37,39,44,50]. Despite the hosting country, evidence shows there is a high level of unawareness regarding CCS among Somali women [37,44,50].…”