Evidence map›Paper›PMID 41388467›Full record

ArticleBMC health services research2025

Expanding access to HPV screening through community health insurance schemes: lessons from a screening exercise for teachers in Ghana.

Kofi Effah, Ethel Tekpor, Joseph Emmanuel Amuah, Elagbe Goka, Comfort Mawusi Wormenor, Richard Armah, Seyram Kemawor, Stephen Danyo, Annita Edinam Dugbazah, Nana Owusu Mensah Essel and 1 more

Abstract read
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kofi EffahCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana.
Ethel TekporCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana.
Joseph Emmanuel AmuahSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
Elagbe GokaNorth Tongu District Health Directorate, Battor, Volta Region, Ghana.
Comfort Mawusi WormenorCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana.
Richard ArmahSt. Andrew Catholic Hospital, Shai Osudoku, Greater Accra Region, P. O. Box AS 261, Kordiabe, Ghana.
Seyram KemaworCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana.
Stephen DanyoCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana.
Annita Edinam DugbazahCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana.
Nana Owusu Mensah EsselDepartment of Emergency Medicine, College of Health Sciences, Faculty of Medicine and Dentistry, University of Alberta, 730 University Terrace, Edmonton, AB, T6G 2T4, Canada.
Emmanuel Timmy DonkohScreen-and-Treat Research Group, Centre for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, P. O. Box 214, Sunyani, Ghana. timmy.donkoh@uenr.edu.gh.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCervical cancer (CC) screening uptake remains low primarily owing to the absence of organized screening and lack of insurance coverage. Members of the Ghana National Association of Teachers (GNAT) contribute monthly to an insurance scheme which covers cancer (including CC) treatment but not cervical precancer screening/treatment. We conducted this study to examine health beliefs shaping cervical screening uptake among educators and to understand how the scheme could scale cervical precancer screening and treatment services for beneficiaries across the country.

methodsFrom February − July 2022, we performed cervical precancer screening with concurrent hr-HPV DNA testing and visual inspection with acetic acid (VIA) for 102 teachers in 3 districts in the Volta Region. From April − May 2024, we conducted a cross-sectional study among 498 female subscribers of the GNAT insurance scheme in the same districts using non-probability snowball sampling. Data on utilization of cervical cancer screening services and risk factors were collected using a self-administered questionnaire. Health beliefs and situational factors associated with screening uptake among school teachers were assessed.

resultsAlthough all 498 female school teachers were enrolled in the cancer insurance scheme, cervical cancer screening uptake was reported by 116 (23.9%). Utilization of cervical cancer screening services was 25.3% among married women and 34.4% among women who reported limited access to screening. In the final adjusted logistic regression model, perceived barriers to screening (aOR, 0.55; 95% CI, 0.42 − 0.72) and being divorced/widowed (aOR, 2.11; 95% CI, 1.10–4.03 vs. married/cohabitating) were independently associated with cervical precancer screening uptake. The hr-HPV prevalence and VIA ‘positivity’ rate were 17.3% (95% CI, 9.9–24.8) and 1.0% (95% CI, 0.0–5.5), respectively.

conclusionsCervical precancer screening utilization among female teachers enrolled in the GNAT cancer insurance scheme was sub-optimal owing to barriers related to low awareness, limited access, and social factors. The cancer insurance scheme represents a golden opportunity to overcome the identified barriers and improve HPV screening access and outcomes in addition to increasing access to cervical cancer treatment and should be explored.

Indexed as

Early Detection of CancerHealth Services AccessibilityInsurance, HealthMass ScreeningPapillomavirus InfectionsSchool TeachersUterine Cervical NeoplasmsAdultCross-Sectional StudiesFemaleGhanaHealth Knowledge, Attitudes, PracticeHuman Papillomavirus VirusesHumansMiddle AgedAcetic acidCervical cancerHuman papilloma virusInsurance coverageSchool teachersScreening uptake

Identifiers

PMID41388467
PMCPMC12817508

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.