Assessment of the availability of colposcopy and the uptake of cervical pre-cancer screening in South Africa, 2023 - 2024: A GIS mapping cross-sectional study
Abstract
Background. Understanding the distribution of public healthcare facilities providing colposcopy services in South Africa (SA) is crucial for informing the prevention of invasive cervical cancer (CC) in this high-HIV-burden country.
Objectives. To assess whether the distribution of colposcopy facilities within the public healthcare system adequately meets demand, and to evaluate the uptake of cervical pre-cancer screening from 1 April 2023 to 31 March 2024.
Method. For this cross-sectional study, data on facilities providing colposcopy services were obtained from CC screening co-ordinators, and data on cervical pre-cancer screening were obtained from the National Health Laboratory Service. We calculated the adequacy of colposcopy facilities using a multivariable location quotient and Quantum GIS software to generate choropleth maps.
Results. In 2023, 87 public healthcare facilities in SA provided colposcopy services, primarily in Gauteng (n=20), Eastern Cape (n=17) and KwaZulu-Natal (n=15) provinces. Despite this, 17% of all districts within provinces lacked these services, and half were unable to meet population needs. North West, Limpopo, Gauteng, Mpumalanga and KwaZulu-Natal provinces also had inadequate distribution of colposcopy facilities. Cervical pre-cancer screening uptake remained <13%, with the lowest screening rates observed in North West, Gauteng and Limpopo provinces. Among women screened, 5.6% had abnormal results. Notably, higher proportions of abnormal…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 20 participants or records.
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