‘We do the impossible’: women overcoming barriers to cervical cancer screening in rural Honduras – a positive deviance analysis

Abstract

Cervical cancer is the leading cause of cancer death for women in Honduras, and sexual behaviour and low screening uptake are two major factors contributing to high rates of morbidity and mortality. A qualitative study was conducted to investigate barriers that prevent rural Honduran women from engaging in screening and ways that women overcome those barriers. This study examined examples of positive deviance, or individuals engaging in the uncommon but beneficial practise of screening. Amor por sí misma (self-love), and social support were identified as two constructs women employed to overcome barriers to screening. Participants defined self-love as the act of displaying care and concern for oneself and one's health and suggested that it compels women to participate in screening. Social support was defined as receiving tangible aid and advice from others that facilitated women's screening participation. Findings suggest that the concept of self-love could be used in future screening promotion efforts and that integrating social support would also be beneficial. Engaging men in sexual and reproductive health programming is suggested in order to ensure male partners offer social support for screening and to challenge the cultural, gender and sexual norms that place women at higher risk for cervical cancer.

Awareness and prevalence of cervical cancer screening among women in Nepal

“…In the Nepali context, illiteracy, inadequate access to health care, and a trend toward accessing health care for curative rather than preventive purposes could explain the low uptake of cervical smear testing [8,19]. Other studies [20,21] have also shown that support from husbands, engaging men in cervical cancer awareness programs, and screening facilities in close proximity to women's residences increases the uptake of cervical smear screening.…”

Current trends in the study of gender norms and health behaviors

“…Studies over the past two decades show that women are sometimes constrained by gender norms that limit their decision making power, and several recent studies echoed these ideas in various settings [68–70]. Studies have highlighted men’s avoidance of help-seeking behaviors as a strategy to demonstrate their masculinity [71].…”

Improve Women’s Health through Integration of Cervical Cancer Screening in Routine Gynecologic Care

“…Furthermore, this integration of cervical cancer screening services will provide an important opportunity to engage male partners to educate them, particularly in counties where men have the dominant role for health care decision [1,9].…”