Implementation of the National Cervical Cancer Screening Programme in the Thabachweu Region of Mpumalanga Province, South Africa

Abstract

Background: The South African National Cervical Cancer Prevention Programme offers three free cervical cytology smears to all women over the age of 30 years at 10-year intervals. The cumulative screening coverage is around 13.7%. Women still present at tertiary institutions with advanced stage cervical cancer. Objective: To quantify the implementation of the National Guideline for Cervical Cancer Screening Programme in the Thabachweu region of Mpumalanga Province, South Africa. Methods: An audit tool was used to select a stratified random sample with proportional allocation of 102 of the 1172 weekly clinic files retrospectively from women aged 30–50 years who consulted at 6 primary health care facilities. Results: Only 15.55% (n = 791) of women consulting at the clinics were screened for cervical cancer with a Pap smear. Of the women screened, 45.20% (n = 357) were given a follow-up Pap smear date. Pap smears were repeated in only 31.74% (n = 159) of the 501 women with suspicious results, while 4.43% (n = 21) of the 474 women with abnormal results were referred for colposcopy. Women treated for cervical cancer were not followed up. Conclusion: The National Cervical Cancer Screening Programme is far from reaching the national screening target of 70%. Implications for Practice: Practice and screening policies at primary health care facilities should be revisited, cervical cancer screening efforts must be scaled up, and challenges health care providers and women experience, explored. Foundational: Women are not adequately being screened, referred and followed up for cervical cancer. Health care providers should engage with patients to raise cervical cancer screening awareness.