Abstract

Every year 311,000 women die of cervical cancer globally, a disease which is preventable and treatable. Pap-testing should be part of a comprehensive approach to tackling cervical cancer, however barriers to pap-testing do exist and migration may present additional barriers. In 2018, 2.3 million Overseas Filipino Workers were recorded and uptake of pap-testing for this group is low. Understanding barriers and enablers to screening for Overseas Filipino Workers is essential to improve uptake of pap-testing for this population.
Embedded in a mixed-methods study, an exploratory qualitative study was conducted with web-based, in-depth interviews (N=8) with female Overseas Filipino Workers, mostly domestic workers, based in Kuwait, Qatar, Singapore and Hong Kong. Results were analysed using thematic analysis. A socio-ecological conceptual framework was used to explore barriers to uptake of pap-testing.
Barriers to pap-testing were cognitive factors, such as limited knowledge and fear of the outcome of pap-testing, as well as cultural and structural barriers. Findings revealed structural contexts not conducive to pap-testing including difficulty navigating the healthcare system, poverty, difficult employment circumstances, and the overriding need to provide financially for family and children in the Philippines.
This study explored barriers to pap-testing with a hard to reach group, who are underrepresented in the literature. Barriers to pap-testing were embedded in structural barriers, resulting in health inequalities. Host and sending countries benefit from Overseas Filipino Workers and have a responsibility to care for their health and well-being, and should strive to tackle these structural factors.