Implementation and Effectiveness of community-based resources to increase cervical cancer screening uptake among women living in sub-Saharan Africa: A protocol for systematic review

Abstract

# Background Sub-Saharan Africa (SSA) accounts for about 70% of the global burden of cervical cancer; this is due to several factors including lack of access to cervical cancer screening, low knowledge of cervical cancer and screening services, poor-functioning health systems, insufficient and poorly trained health workers, and the high burden of human immunodefiency virus (HIV) infection. To date, to the best of our knowledge, there has been no systematic review of the literature on the role of community-based resources such as community health workers and community-based organisations in increasing the uptake and or continuing participation of women in cervical cancer screening, in the setting of high HIV burden, in sub-Saharan Africa. # Methods We will systematically search selected databases and websites from 1980 to date for published and grey literature including citation and reference list tracking, on studies with a community focus carried out in sub-Saharan Africa, without language restrictions. Randomised controlled trials (RCTs), observational studies, and qualitative and mixed methods studies of interventions (carried out with and without comparison groups) reporting impact on participation in cervical cancer screening in sub-Saharan Africa will be identified and assessed for methodological quality by two independent reviewers. We will use narrative synthesis and/or meta-analysis depending on the study selection. # Results Findings will be summarised into abstracts for presentation at conferences and submission to peer-reviewed journals in the field for wide-ranging dissemination to patients, researchers, healthcare professionals and policy makers on cervical cancer in sub-Saharan Africa. # Conclusion The review will address the gap in evidence for effective and implementable community-based strategies that encourages uptake of cervical cancer screening among women living in sub-Saharan Africa. The findings will have the potential to inform future screening practice and research with the hope of reducing the burden of cervical cancer in the region. # PROSPERO registration number -- CRD42018102539.