Barriers to Cervical Screening among Pacific Women in a New Zealand Urban Population

  • Foliaki, Sunia (Centre for Public Health Research, Massey University) ;
  • Matheson, Anna (Centre for Public Health Research, Massey University)
  • Published : 2015.03.09


Background: In Aotearoa/New Zealand cervical screening programmes have reduced cervical cancer; however, half of cervical cancer cases among Pacific women are found among clients who had not attended cervical screening. Hence, we set out to determine health provider perspectives on barriers that prevent their services reaching Pacific women within Aotearoa/New Zealand. Materials and Methods: Twenty semi-structured interviews were conducted with health care providers, Pap smear takers and community workers in the Wellington region. Participants were asked their views on factors that enabled and/or constrained the participation of Pacific women in their cervical screening services. Results: Six interrelated themes influencing participation in cervical screening among Pacific women in the Wellington region were apparent: the funding and practice of service delivery; family always coming first; the cost of screening services; type of employment; the appropriateness of information; and attitudes to self and screening. Conclusions: Determining specific ethnic group actual health needs and meeting them contributes to overall improvement in New Zealand's health status. The results identified the need for improvements to the delivery of screening services including adapting cervical screening services to the requirements of Pacific women through more outreach services at alternate clinic hours; culturally appropriate practitioners; the ability to take up opportunities for health checks and foster long-term relationships; as well as appropriate monitoring and evaluation of approaches. Funding and reporting relationships also need to be compatible with the goal of improving outcomes for Pacific women. Further research into client voices for their particular needs to compliment the service provider perspective as well as minority groups is called for.


Cervical cancer;screening;pacific women;Aotearoa/New Zealand


  1. Chen MS Jr, Koh HK (1997). The need for cancer prevention and control among Asian Americans and Pacific Islanders. Asian Am Pac Isl J Health, 5, 3-6.
  2. Cory J, Bottum C, Haddock C (1995). Evaluating print health education materials. Cancer Pract, 3, 54-6.
  3. Cox B, Skegg DC (1992). Projections of cervical cancer mortality and incidence in New Zealand: the possible impact of screening. J Epidemiol Community Health, 46, 373-7.
  4. Cumming J, Mays N (2002). Reform and counter reform: how sustainable is New Zealand's latest health system restructuring? J Health Serv Res Policy, 7, 46-55.
  5. Cumming J, Mays N, Gribben B (2008). Reforming primary health care: is New Zealand's primary health care strategy achieving its early goals? Aust New Zealand Health Policy, 5, 24.
  6. Dang J, Lee J, Tran JH, et al (2010). The role of medical interpretation on breast and cervical cancer screening among Asian American and pacific islander women. J Cancer Educat, 25, 253-262.
  7. Foliaki, S, Best D, Akau'ola S, et al (2011). Cancer incidence in four pacific countries: Tonga, Fiji Islands, Cook Islands and Niue. Pac Health Dialog, 17, 21-32.
  8. Foliaki S, Jeffreys M, Wright C, Blakey K, Pearce N (2004). Cancer in Pacific people in New Zealand: a descriptive study. Pac Health Dialog, 11, 94-100.
  9. Jameson A, Sligo F, Comrie M (1999). Barriers to pacific women's use of cervical screening services. Aust N Z J Public Health, 23, 89-92.
  10. Lovell S, Kearns RA, Friesen W (2007). Sociocultural barriers to cervical screening in South Auckland, New Zealand. Soc Sci Med, 65, 138-50.
  11. Ludeke, M, Puni R, Cook L, et al (2012). Access to general practice for Pacific peoples: a place for cultural competency. J Prim Health Care, 4, 123-30.
  12. Mehmetoglu HC, Sadikoglu G, Ozcakir A, Bilgel N (2010). Pap smear screening in the primary health care setting: A study from Turkey. N Am J Med Sci, 2, 467-72.
  13. Meredith I, Sarfati D, Ikeda T, Atkinson J, Blakely T (2012). High rates of endometrial cancer among Pacific women in New Zealand: the role of diabetes, physical inactivity, and obesity. Cancer Causes Control, 23, 875-85.
  14. Minister of Health and Minister of Pacific Island Affairs (2010). Ala Mo'ui: pathways to pacific health and wellbeing 2010-2014. edited by Ministry of Health. Wellington
  15. Obel J, Souares Y, Hoy D, et al (2014). A systematic review of cervical cancer incidence and mortality in the Pacific Region. Asian Pac J Cancer Prev, 15, 9433-7.
  16. Sheridan NF, KenealyTW, Connolly MJ, et al (2011). Health equity in the New Zealand health care system: a national survey. Int J Equity Health, 10, 45.
  17. Sligo F, Jameson A, Comrie M (1998). New Zealand polynesian women's access to information about cervical screening. J Manag Med, 12, 361-9.
  18. Taylor VM, Jackson JC, Schwartz SM, Tu SP, Thompson B (1996). Cervical cancer among Asian American women: a neglected publica health problem? Asian Am Pac Isl J Health, 4, 327-42.