cervical cancer

Cervical Screening in South Tarawa, Kiribati

Introduction

• Background

  • Cervical cancer is a critical public health concern in Kiribati, significantly affecting morbidity and mortality among women.

  • The disease is largely preventable through effective cervical screening.

• Need for Research

  • Empirical research is essential to understand the attitudes, barriers, and knowledge regarding cervical screening among I-Kiribati women to improve uptake rates.

Methods

• Approach

  • A mixed-methods approach combined community surveys and focus groups.

  • Surveys were conducted with 90 participants (26 men, 63 women) and focus groups with 15 individuals to gather qualitative insights.

• Data Collection

  • Surveys focused on awareness, knowledge, uptake, reasons for attendance or non-attendance, and responses from male family members.

  • Data were collected in the local language (I-Kiribati) and included systematic recruitment through door-to-door visits.

Findings

Knowledge and Awareness

• General Knowledge Levels

  • Knowledge about cervical screening was low—particularly concerning symptoms and the procedure (only 39% of females knew where to go for a Pap smear).

  • The average recommendation for screening intervals (3 years) was largely unknown.

• Information Sources

  • Volunteers provided the primary source of information on screening (45%), suggesting community outreach plays a vital role in awareness.

Attendance and Uptake

• Current Statistics

  • Only 32% of female respondents reported ever having a Pap smear; 44% had one within the last three years.

• Drivers for Attendance

  • Main motivators included experiencing health issues (41%) or being encouraged by others (31%).

Barriers to Access

• Common Barriers Identified

  • Embarrassment (24%), fear of results, lack of information, feeling healthy, and cultural beliefs about appropriateness.

  • Jealousy from male family members is a significant barrier.

• Institutional Barriers

  • Lack of access to suitable, skilled services, especially in remote areas, and negative past experiences with the healthcare system affect participation.

Facilitators for Participation

• Support Systems

  • Importance of support from male family members identified as a facilitator.

  • Community workshops, mobile clinics, and health education are potential strategies to increase attendance.

• Reminder Systems

  • Emphasis on personal reminders and integrating screening with family planning services for better accessibility.

Discussion

• Cultural Context

  • Men are often decision-makers regarding women's health, which influences cervical screening participation.

• Need for Health Promotion

  • Targeted health promotion campaigns can normalize cervical screening and address fears, politics of masculinity, and misconceptions.

• Recommendations to Improve Uptake

  • Create educational materials to wisely inform about cervical cancer and screening.

  • Develop culturally sensitive community engagement strategies to increase knowledge and address barriers.

Conclusion

• Call for Action

  • Significant room for improvement in increasing the understanding and availability of cervical screening in Kiribati.

  • Health resources need to be enhanced through community-driven initiatives that address local beliefs and practices.