Barriers and facilitators to pap-testing among female overseas Filipino workers: a qualitative exploration

Abstract

Purpose 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. The study aims to understand barriers and enablers to screening for overseas Filipino workers, which is essential to improve uptake of pap-testing for this population. Design/methodology/approach 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. Findings 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 health-care system, poverty, difficult employment circumstances and the overriding need to provide financially for family and children in the Philippines. Originality/value 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.