Cervical Cancer Screening and Prevention in Sub-Saharan Africa: Health System Constraints, Gender Dynamics, and Implications for Public Health Management

Abstract

Background: Cervical cancer remains a leading cause of cancer-related morbidity and mortality among women in sub-Saharan Africa, despite the availability of effective screening, early treatment, and preventive interventions. Persistently high incidence and mortality rates suggest that the challenge extends beyond biomedical limitations to include systemic health system constraints and gender-related barriers that shape access, uptake, and continuity of care.

Methods: This empirical study employs secondary data analysis drawing on regional and country-level datasets from global health agencies and publicly available epidemiological repositories. Data on cervical cancer burden, screening coverage, HIV prevalence, health system capacity, and prevention strategies were analyzed using a thematic and descriptive analytical framework. The study adopts a health systems and gender-responsive lens to examine how structural and sociocultural factors interact to influence screening and prevention outcomes across sub-Saharan Africa.

Results: Findings indicate persistently low and uneven screening coverage across the region, with pronounced disparities between urban and rural populations and between high HIV-burden and lower-burden settings. Health system challenges including inadequate infrastructure, workforce shortages, weak referral mechanisms, and fragmented service delivery significantly constrain effective implementation of screening and treatment services. Gender norms, limited decision-making autonomy, stigma, and low awareness further reduce service uptake. While low-cost screening methods and HPV vaccination initiatives demonstrate measurable effectiveness, their population-level impact remains limited by inconsistent implementation and inequitable reach.

Conclusion: The continued burden of cervical cancer in sub-Saharan Africa reflects the convergence of health system weaknesses and gendered social realities. Addressing this burden requires gender-responsive health system strengthening, integration of cervical cancer services within primary healthcare and HIV platforms, and sustained investment in equitable screening and vaccination programs. Such approaches are essential for accelerating progress toward cervical cancer elimination and improving women’s health outcomes in the region.