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Health care access dimensions and cervical cancer screening in South Africa: analysis of the world health survey

Overview of attention for article published in BMC Public Health, April 2015
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Title
Health care access dimensions and cervical cancer screening in South Africa: analysis of the world health survey
Published in
BMC Public Health, April 2015
DOI 10.1186/s12889-015-1686-5
Pubmed ID
Authors

Tomi F Akinyemiju, Jasmine A McDonald, Paula M Lantz

Abstract

Cervical cancer is the most commonly diagnosed cancer and the leading cause of cancer mortality among women in sub-Saharan Africa. Recent recommendations for cervical cancer primary prevention highlight HPV vaccination, and secondary prevention through screening. However, few studies have examined the different dimensions of health care access, and how these may influence screening behavior, especially in the context of clinical preventive services. Using the 2003 South Africa World Health Survey, we determined the prevalence of cervical cancer screening with pelvic examinations and/or pap smears among women ages 18 years and older. We also examined the association between multiple dimensions of health care access and screening focusing on the affordability, availability, accessibility, accommodation and acceptability components. About 1 in 4 (25.3%, n = 65) of the women who attended a health care facility in the past year got screened for cervical cancer. Screened women had a significantly higher number of health care providers available compared with unscreened women (mean 125 vs.12, p-value <0.001), and were more likely to have seen a medical doctor compared with nurses/midwives (73.1% vs. 45.9%, p-value = 0.003). In multivariable analysis, every unit increase in the number of health care providers available increased the likelihood of screening by 1% (OR = 1.01, 95% CI: 1.00, 1.01). In addition, seeing a nurse/midwife compared to a medical doctor reduced the likelihood of screening by 87% (OR = 0.13, 95% CI: 0.04, 0.42). Our findings suggest that cost issues (affordability component) and other patient level factors (captured in the acceptability, accessibility and accommodation components) were less important predictors of screening compared with availability of physicians in this population. Meeting cervical cancer screening and HPV vaccination goals will require significant investments in the health care workforce, improving health care worker density in poor and rural areas, and improved training of the existing workforce.

Mendeley readers

The data shown below were compiled from readership statistics for 151 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 151 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 45 30%
Researcher 17 11%
Other 10 7%
Student > Postgraduate 10 7%
Student > Ph. D. Student 10 7%
Other 30 20%
Unknown 29 19%
Readers by discipline Count As %
Medicine and Dentistry 43 28%
Nursing and Health Professions 35 23%
Social Sciences 15 10%
Psychology 8 5%
Economics, Econometrics and Finance 6 4%
Other 12 8%
Unknown 32 21%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 May 2015.
All research outputs
#4,230,528
of 5,085,441 outputs
Outputs from BMC Public Health
#5,185
of 5,536 outputs
Outputs of similar age
#135,494
of 163,486 outputs
Outputs of similar age from BMC Public Health
#196
of 211 outputs
Altmetric has tracked 5,085,441 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 5,536 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.6. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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We're also able to compare this research output to 211 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.