Socioeconomic inequalities in cervical cancer screening in sub-Saharan Africa: Decomposition analysis

Ahinkorah, B; Aboagye, R; Okyere, J; Essuman, M; Seidu, A; Wongnaah, A

Socioeconomic inequalities in cervical cancer screening in sub-Saharan Africa: Decomposition analysis

Ahinkorah, B

Aboagye, R Okyere, J Essuman, M Seidu, A Wongnaah, A

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Publisher:: Oxford University Press (OUP)
Publication Type:: Journal Article
Citation:: European Journal of Public Health, 2024, 34, (Supplement_3), pp. ckae144.952
Issue Date:: 2024-11-01

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Field	Value	Language
dc.contributor.author	Ahinkorah, B https://orcid.org/0000-0001-7415-895X
dc.contributor.author	Aboagye, R
dc.contributor.author	Okyere, J
dc.contributor.author	Essuman, M
dc.contributor.author	Seidu, A
dc.contributor.author	Wongnaah, A
dc.date.accessioned	2025-04-02T05:50:56Z
dc.date.available	2025-04-02T05:50:56Z
dc.date.issued	2024-11-01
dc.identifier.citation	European Journal of Public Health, 2024, 34, (Supplement_3), pp. ckae144.952
dc.identifier.issn	1101-1262
dc.identifier.issn	1464-360X
dc.identifier.uri	http://hdl.handle.net/10453/186495
dc.description.abstract	Abstract sec Background p Cervical cancer remains prevalent in sub-Saharan Africa (SSA). Despite global efforts to eliminate this disease, its incidence continues to rise due to barriers in screening, vaccination, and treatment access. While studies address access barriers, little has explored inequality, often limited to single countries. Here, we examine socioeconomic inequalities in cervical cancer screening in SSA. /p /sec sec Methods p Data from the Demographic and Health Surveys of 10 SSA countries was used for the analysis. We stratified the study by wealth index and educational attainment as a measure of socioeconomic status. Socioeconomic status inequalities in cervical cancer screening were constructed using concentration curves. We then computed the concentration index to quantify socioeconomic inequality. To examine the factors associated with high socioeconomic inequality in cervical cancer screening, a decomposition analysis was conducted. /p /sec sec Results p Concentration curves showed screening uptake skewed towards the wealthy and educated across all countries, reflected by positive concentration indices (CIX 0.21 p-valueandlt 0.0001) except in Burkina Faso and Mauritius. Decomposition analysis revealed significant positive concentration indices for women with complete secondary (CIX 0.74) and higher education (CIX 0.91), those in the richest wealth index (CIX 0.35), separated women (CIX 0.08), currently working women (CIX 0.02), as well as those who were exposed to reading newspaper/magazine (CIX 0.19), listening to radio (CIX 0.10), and watching TV (CIX 0.44). /p /sec sec Conclusions p Cervical cancer screening in SSA exhibits pro-rich and pro-higher educational inequalities. Urgent interventions are needed to restructure existing screening programs to prioritize accessibility and inclusion, particularly for women from poorer households and with a lower level of education. These findings are vital for policymakers and public health practitioners
dc.language	en
dc.publisher	Oxford University Press (OUP)
dc.relation.ispartof	European Journal of Public Health
dc.relation.isbasedon	10.1093/eurpub/ckae144.952
dc.rights	info:eu-repo/semantics/openAccess
dc.rights	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.subject	1117 Public Health and Health Services
dc.subject.classification	Public Health
dc.subject.classification	4202 Epidemiology
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4206 Public health
dc.title	Socioeconomic inequalities in cervical cancer screening in sub-Saharan Africa: Decomposition analysis
dc.type	Journal Article
utslib.citation.volume	34
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/DVC (Research)
utslib.copyright.status	open_access	*
pubs.consider-herdc	true
dc.date.updated	2025-04-02T05:50:55Z
pubs.issue	Supplement_3
pubs.publication-status	Published
pubs.volume	34
utslib.citation.issue	Supplement_3

Abstract:

Abstract sec Background p Cervical cancer remains prevalent in sub-Saharan Africa (SSA). Despite global efforts to eliminate this disease, its incidence continues to rise due to barriers in screening, vaccination, and treatment access. While studies address access barriers, little has explored inequality, often limited to single countries. Here, we examine socioeconomic inequalities in cervical cancer screening in SSA. /p /sec sec Methods p Data from the Demographic and Health Surveys of 10 SSA countries was used for the analysis. We stratified the study by wealth index and educational attainment as a measure of socioeconomic status. Socioeconomic status inequalities in cervical cancer screening were constructed using concentration curves. We then computed the concentration index to quantify socioeconomic inequality. To examine the factors associated with high socioeconomic inequality in cervical cancer screening, a decomposition analysis was conducted. /p /sec sec Results p Concentration curves showed screening uptake skewed towards the wealthy and educated across all countries, reflected by positive concentration indices (CIX 0.21 p-valueandlt 0.0001) except in Burkina Faso and Mauritius. Decomposition analysis revealed significant positive concentration indices for women with complete secondary (CIX 0.74) and higher education (CIX 0.91), those in the richest wealth index (CIX 0.35), separated women (CIX 0.08), currently working women (CIX 0.02), as well as those who were exposed to reading newspaper/magazine (CIX 0.19), listening to radio (CIX 0.10), and watching TV (CIX 0.44). /p /sec sec Conclusions p Cervical cancer screening in SSA exhibits pro-rich and pro-higher educational inequalities. Urgent interventions are needed to restructure existing screening programs to prioritize accessibility and inclusion, particularly for women from poorer households and with a lower level of education. These findings are vital for policymakers and public health practitioners

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