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<p>Cervical cancer remains a leading cause of cancer-related mortality among women in Sub-Saharan Africa, particularly in Zambia, despite the preventability of the disease through vaccination, early screening, and treatment. This narrative review explores the current landscape of cervical cancer prevention in low- and middle-income countries (LMICs), highlighting the role and limitations of health education in driving screening uptake to inform the Zambian cervical cancer program. A comprehensive literature search was conducted using four of the largest health sciences electronic databases, MEDLINE/PubMed, Science Direct, EBSCOHost, and Google Scholar to identify relevant articles. A stepwise screening of titles, abstract and full texts was followed. A total of 58 articles were included in the review. While numerous health education initiatives across LMICs, such as media campaigns, school-based curricula, and community outreach, have demonstrated increased awareness, they have not consistently translated into higher screening participation. This review revealed multi-country evidence that knowledge alone does not guarantee behavior change. Key enablers, including self-efficacy, access to services, social support, and cultural acceptability, are crucial determinants of health-seeking behavior, aligning with behavior change models such as the Health Belief Model and Social Cognitive Theory. In LMICs, structural barriers, including insufficient resources, provider shortages, and logistical challenges, compound low awareness and cultural stigma. However, promising strategies such as Human Papilloma Virus self-sampling, integration of screening with HIV programs, and the use of community-based volunteers offer scalable, context-sensitive solutions. Despite recent efforts, LMICs still face significant gaps in screening coverage, particularly in rural areas, and limited evaluation of program effectiveness. Future interventions must focus on tailoring health education to local realities, integrating services into existing health platforms, and strengthening community engagement to achieve the WHO’s 2030 cervical cancer elimination targets.</p>

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Health education programs and cervical cancer control in resource limited settings: a narrative review

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年11月17日

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  • Moreblessing Mashora,
  • Myra Taylor,
  • Siyabonga Dlamini

摘要

Cervical cancer remains a leading cause of cancer-related mortality among women in Sub-Saharan Africa, particularly in Zambia, despite the preventability of the disease through vaccination, early screening, and treatment. This narrative review explores the current landscape of cervical cancer prevention in low- and middle-income countries (LMICs), highlighting the role and limitations of health education in driving screening uptake to inform the Zambian cervical cancer program. A comprehensive literature search was conducted using four of the largest health sciences electronic databases, MEDLINE/PubMed, Science Direct, EBSCOHost, and Google Scholar to identify relevant articles. A stepwise screening of titles, abstract and full texts was followed. A total of 58 articles were included in the review. While numerous health education initiatives across LMICs, such as media campaigns, school-based curricula, and community outreach, have demonstrated increased awareness, they have not consistently translated into higher screening participation. This review revealed multi-country evidence that knowledge alone does not guarantee behavior change. Key enablers, including self-efficacy, access to services, social support, and cultural acceptability, are crucial determinants of health-seeking behavior, aligning with behavior change models such as the Health Belief Model and Social Cognitive Theory. In LMICs, structural barriers, including insufficient resources, provider shortages, and logistical challenges, compound low awareness and cultural stigma. However, promising strategies such as Human Papilloma Virus self-sampling, integration of screening with HIV programs, and the use of community-based volunteers offer scalable, context-sensitive solutions. Despite recent efforts, LMICs still face significant gaps in screening coverage, particularly in rural areas, and limited evaluation of program effectiveness. Future interventions must focus on tailoring health education to local realities, integrating services into existing health platforms, and strengthening community engagement to achieve the WHO’s 2030 cervical cancer elimination targets.