Access to cervical cancer care in sub-Saharan Africa: a narrative review of barriers and opportunities.

BACKGROUND: This narrative review examines the barriers and opportunities that shape access and delivery of cervical cancer care services in sub-Saharan Africa. Unlike prior studies that only focused on single phases of care, this review adopts a comprehensive perspective by assessing access across the full cervical cancer care continuum. METHODS: A narrative review was conducted using six databases (Embase, Medline, Web of Science, Scopus, African Index Medicus, and CINAHL Plus). The included studies were thematically analyzed, and emerging themes were interpreted through the lens of the five dimensions of healthcare access: accessibility, availability, affordability, acceptability, and accommodation. RESULTS: Across 38 included studies, findings identified three overarching categories of barriers. (1) Individual-level barriers, including knowledge and awareness, socio-demographic and economic factors, and attitudes and beliefs; (2) Community-level barriers, including cultural acceptance and social norms, and community and social support networks, which further constrained engagement with services; and (3) Health-system-level barriers, including resource limitations, service delivery and quality, and weak policy implementation, which compounded delays and limited care effectiveness. Moreover, opportunities, such as methodological opportunities (community-driven health education, culturally informed healthcare interventions, and multi-stakeholder engagement) and technological opportunities (technology-enhanced health education, digital systems for patient navigation, and task decentralization using mobile health platforms, telehealth, electronic health records, and digital reminder systems), could be effectively integrated into the healthcare system to improve access and service delivery. CONCLUSION: Access to cervical cancer care in sub-Saharan Africa is shaped by interconnected structural, sociocultural, and individual barriers that extend beyond supply and service availability alone. Literature often focuses on screening, diagnosis, and treatment of cervical cancer, while research gaps identified in this review persist in primary prevention, follow-up, and palliative care services. Findings from the review suggest that integrated, context-specific, and human-centered healthcare interventions are needed to strengthen care coordination, improve access, and enhance care outcomes.