Toolkit for engaging Under-screened and Never-screened women in the National Cervical Screening Program
Women who live in remote areas of Australia have generally poorer health and wellbeing than women in urban areas. There is a higher incidence of cervical cancer in remote and very remote areas which is likely to be related to the proportionally high number of Aboriginal and Torres Strait Islander women living in these areas.
Although the cervical screening participation rates in remote areas are only slightly lower than those in regional and urban areas, women in remote areas face particular barriers to participation. These barriers are related to access to health services, socioeconomic disparities and privacy issues.
Barriers to screeningIn addition to the general barriers women may face in participating in cervical screening, the following barriers have been identified as common for women from remote areas.
Barriers to screening for Womem from remote areas
- Less access to health services compared to those living in major cities – for example, fewer GPs, fewer female GPs, fewer GPs who bulk-bill, less after-hours services, less hours when GPs are available and greater waiting times for appointments.
- Geographical remoteness – greater distance to services.
- Socioeconomic disparities (i.e. lower education and income).
- In rural and remote towns women may develop a personal relationship with their healthcare provider. Not all women want to have a close relationship with their cervical screening provider. The lack of social distance in a small town may lead to the lack of privacy.
- Out of pocket costs for health services.
Engagement strategiesStrategies for engaging women from remote areas in cervical screening relate to improving access to screening and to addressing privacy concerns.
- Mobile and outreach services have been effective in engaging women from remote areas in cervical screening.
- Consider flexible appointments, group transportation and/or transportation assistance.
- Offer opportunistic screening where possible.
- Reduce or eliminate fees for women with a healthcare card.
- Ensure women understand that their privacy and confidentiality will be maintained.