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Residency-Based Inequalities in Cervical Cancer Screening in Sub-Saharan Africa
Robert Kokou Dowou1, Samuel Salu1, Janet Ama Takyiwaa2
1Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana.
Tropical Medicine & International Health : TM & IH
|August 2, 2026
Summary
Rural women in sub-Saharan Africa have significantly lower cervical cancer screening uptake than urban women. Disparities are mainly due to education, wealth, parity, and media exposure, necessitating targeted public health interventions.
Area of Science:
- Public Health
- Epidemiology
- Health Disparities
Background:
- Cervical cancer screening uptake remains low in sub-Saharan Africa.
- Significant rural-urban disparities in screening uptake have been observed.
- Understanding the drivers of these disparities is crucial for effective interventions.
Purpose of the Study:
- To examine the factors contributing to rural-urban disparities in cervical cancer screening uptake in sub-Saharan Africa.
- To quantify the impact of women's characteristics versus other factors on this disparity.
Main Methods:
- Utilized data from Demographic and Health Surveys in 14 sub-Saharan African countries.
- Included a weighted sample of 66,958 women aged 30-49 years.
- Employed a multivariate nonlinear decomposition model to analyze rural-urban differences.
Main Results:
- Pooled cervical cancer screening uptake was 21.2% in urban and 11.6% in rural areas.
- Women's characteristics explained 106.53% of the rural-urban disparity.
- Education, parity, wealth index, and mass media exposure were key contributing factors.
Conclusions:
- Rural-urban disparities in cervical cancer screening uptake are substantial in sub-Saharan Africa.
- Educational attainment, parity, wealth, and media exposure significantly drive these disparities.
- Multifaceted public health strategies are needed to improve rural screening access and tailor interventions.
