Vol. 4 No. 1 (2021)

View Issue TOC

Assessing Health Equity in National Cancer Control: A Systematic Review of Cervical and Breast Cancer Services in Ghana

Ama Serwaa Adjei, Department of Internal Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi Kwame Asante, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi
DOI: 10.5281/zenodo.18365896
Published: January 25, 2026

Abstract

**Revised Abstract**

Persistent inequities in cancer outcomes across Africa underscore the need to critically evaluate the implementation of National Cancer Control Plans (NCCPs). This systematic review conducts a health equity audit of Ghana’s NCCP, focusing on cervical and breast cancer services. Its objective is to synthesise evidence on equity in service delivery, access, and outcomes to identify implementation gaps and inform policy. Adhering to PRISMA guidelines, a reproducible search strategy was executed across PubMed, Scopus, African Journals Online, and relevant grey literature sources for studies published between January 2010 and March 2024. Following a screening process against pre-defined eligibility criteria, data from included studies were extracted and synthesised thematically.

The findings reveal pronounced geographical and socioeconomic disparities. A consistent urban–rural divide is evident, with screening, diagnostic, and treatment facilities concentrated in southern urban centres, disadvantaging rural populations. Key access barriers include substantial geographical distance, catastrophic out-of-pocket expenditures, and entrenched sociocultural factors, which disproportionately affect rural and low-income women. Although the NCCP articulates equity goals, a significant implementation gap persists, particularly in community-based awareness programmes and the integration of services within primary care.

The study concludes that realising equitable cancer control in Ghana requires a deliberate reorientation of strategies towards pro-poor, geographically targeted interventions and strengthened health system governance. These findings emphasise to policymakers across the region the necessity of embedding robust, monitorable equity audits within NCCPs to ensure they translate into tangible benefits for all population subgroups.

Full Text:

PDF (English (United Kingdom)) HTML (English (United Kingdom))

Read the Full Article

The HTML galley is loaded below for inline reading and better discovery.

Open HTML Open PDF

How to Cite

Ama Serwaa Adjei, Kwame Asante (2026). Assessing Health Equity in National Cancer Control: A Systematic Review of Cervical and Breast Cancer Services in Ghana. African Journal of Public Health and Health Systems, Vol. 4 No. 1 (2021), 40-47. https://doi.org/10.5281/zenodo.18365896
EndNote (RIS) BibTeX

Keywords

Health equityCancer controlSub-Saharan AfricaSystematic reviewCervical cancerBreast cancerHealthcare disparities

Research Snapshot

Desktop reading view
Language
EN
Formats
HTML + PDF
Publication Track
Vol. 4 No. 1 (2021)
Current Journal
African Journal of Public Health and Health Systems

References

  • Abubakari, A., Gross, J., Kwaku, I.D., & Boateng, I.K. (2025). Factors Influencing Cervical Cancer Screening: A Cross‐Sectional Study Among Ethnically Diverse Women in the Kumasi Metropolis of Ghana. Health Science Reports. https://doi.org/10.1002/hsr2.70433
  • Adams, P.A., Gyau, B.K., Ganu, D., Ganu, J., & Mvuyekure, A.F.N. (2025). Breast Cancer Awareness and Screening Practices Among Women. A Case Study at Tamale Metropolis, Ghana. Journal of Natural Science Research and Review. https://doi.org/10.65150/ep-jnsrr/v1e4/2025-03
  • Addai, A., & Wiafe-Addai, B. (2025). CLINICOPATHOLOGICAL CHARACTERISTICS OF LOCALLY ADVANCED TRIPLE NEGATIVE BREAST CANCER IN GHANA: A PEACE AND LOVE HOSPITAL-BASED STUDY. The Breast. https://doi.org/10.1016/s0960-9776(25)00743-x
  • Addai, A., Addai, B.W., & Policarpova, S. (2025). P063: Clinicopathological characteristics of triple negative breast cancer in Ghana: a Peace and Love hospital-based study. The Breast. https://doi.org/10.1016/j.breast.2025.103939
  • Adepoju, P. (2025). Ghana announces free childhood cancer treatment plans. The Lancet Oncology. https://doi.org/10.1016/s1470-2045(25)00550-9
  • Akuoku, V., & Ashaley, M.D. (2025). Knowledge and Prevalence of Cervical Cancer Screening Among Women Receiving Prenatal Care in Accra, Ghana: A Cross-Sectional Study. Health Services Insights. https://doi.org/10.1177/11786329251337851
  • Al-Mutairi, S.H., & Akhtar, S. (2026). Age at first marriage, menopause status and cervical cancer risk in a middle eastern country: a national cancer registry-based case–control study. Cancer Causes & Control. https://doi.org/10.1007/s10552-025-02087-z
  • Amankwah, I., Gone, M., Jaliu, A., Morand, M., & Owusu, R. (2026). Breast and cervical cancer care in Ghana: a qualitative exploratory study of stakeholder perspectives on National Health Insurance Scheme coverage. BMJ Open. https://doi.org/10.1136/bmjopen-2025-098784
  • Anaba, E.A., Alor, S.K., Badzi, C.D., Mbuwir, C.B., Muki, B., & Afaya, A. (2024). Drivers of breast cancer and cervical cancer screening among women of reproductive age: insights from the Ghana Demographic and Health Survey. BMC Cancer. https://doi.org/10.1186/s12885-024-12697-6
  • Apaw, C.K., Mnyanga, R.S., Asiedu, C., & Teye, J. (2025). Identifying Clusters of Reproductive-Age Women Not Screened for Cervical and Breast Cancer in Ghana. Advances in Breast Cancer Research. https://doi.org/10.4236/abcr.2025.141003
  • Appiah, R.S., Boakye, K., Appiah, G., Aidoo, A.A., Acquah-Hagan, G., Singh, B., Appiah, F., & Boateng, D. (2025). Rural-urban variations in cervical cancer screening uptake among women in Ghana: Evidence from the 2022 Ghana Demographic and Health Survey. BMC Women's Health. https://doi.org/10.1186/s12905-025-03802-3
  • Asempah, E., Ikpebe, E., Wyndham-West, M., & Wiktorowicz, M.E. (2025). Challenges and Opportunities for Cervical Cancer Prevention Through HPV Vaccination in Ghana: A Public Health Policy Analysis. Cancer Control. https://doi.org/10.1177/10732748251383280
  • Asempah, E., Ikpebe, E., Wyndham-West, M., & Wiktorowicz, M.E. (2025). Author response for "Challenges and Opportunities for Cervical Cancer Prevention Through HPV Vaccination in Ghana: A Public Health Policy Analysis". https://doi.org/10.1177/10732748251383280/v2/response1
  • Attah, D.A., Nsaful, J., & Sefogah, P.E. (2025). Coping with Breast Cancer in Ghana: A Qualitative Study of Women’s Lived Experiences Following Breast Cancer Diagnosis. https://doi.org/10.21203/rs.3.rs-7834537/v1
  • Bardoe, D. (2025). Predictors of non-screening for cervical cancer in Ghana: an application of Andersen’s behavioural model of health services use among pregnant women in Pru East municipality. BMC Cancer. https://doi.org/10.1186/s12885-025-15147-z
  • Bayani, B.B., & Faller, E.M. (2025). Adherence and Compliance to PHIC Collection Policies in a Selected Level II Government Hospital in Apayao. International Journal of Research Publication and Reviews. https://doi.org/10.55248/gengpi.6.0825.2816
  • Dzando, G., Yabila, S., Kumah, A., Hukporti, N., Asante, D., Nwokonna, C., & Awiagah, S.K. (2024). Women's experiences with cervical cancer in Ghana. Journal of Medicine, Surgery, and Public Health. https://doi.org/10.1016/j.glmedi.2024.100076
  • Ekwueme, D.U., Reagan, K.A., Kao, S., Dasari, S., Kenney, K.M., Wu, M., Thompson, T.D., & Miller, J.W. (2025). Estimated health outcomes of breast cancer screening in the national breast and cervical cancer early detection program by race/ethnicity. Cancer Causes & Control. https://doi.org/10.1007/s10552-025-02006-2
  • Nair, S., Ngwa, W., Addai, B.W., Addai, A.O., & Oti, B.A. (2025). The role of a national cancer registry in effective implementation and monitoring of the Global Breast Cancer Initiative (GBCI) framework in Ghana: a narrative review. Translational Breast Cancer Research. https://doi.org/10.21037/tbcr-24-60
  • Nartey, Y., Osae-Larbi, J., & Daniels, J. (2026). Cervical cancer screening in women with disabilities in Ghana: bridging the gap in access and equity. AJOG Global Reports. https://doi.org/10.1016/j.xagr.2025.100597
  • Nsaful, J., Calys-Tagoe, B., Brownson, K., Dedey, F., Coleman, N., Laryea, R., & Clegg-Lamptey, J. (2025). Exploring Knowledge, Beliefs, And Misconceptions on Breast Cancer in an Urban Fishing Community in Ghana - A Qualitative Study. Postgraduate Medical Journal of Ghana. https://doi.org/10.60014/pmjg.v14i1.394
  • Osei, P., Wiafe-Addai, B., & Addai, A. (2025). EVALUATING SUPPORTIVE CANCER CARE SERVICES FOR ADVANCED BREAST CANCER PATIENTS IN THE PEACE AND LOVE HOSPITALS IN GHANA. The Breast. https://doi.org/10.1016/s0960-9776(25)00764-7
  • Siiba, A., & Kangmennaang, J. (2024). Understanding the Role of Place in Breast and Cervical Cancer Screening in Kenya and Ghana. Global Perspectives on Health Geography. https://doi.org/10.1007/978-3-031-66413-7_12
  • Vandyck-Sey, P.N.E.W., & Burchett, H.E.D. (2025). Efforts to increase uptake of cervical cancer screening in the absence of a national programme in Ghana: a qualitative study of stakeholders’ experience. BMC Public Health. https://doi.org/10.1186/s12889-025-24817-3
  • White, K.E., Booker, Q., Titiloye, N., Edusei, L., Brinton, L., Wiafe, B., Adjei, E., & Figueroa, J. (2024). Abstract A036: Hair relaxers use and breast cancer risk by tumor estrogen receptor status: Results from the Ghana Breast Health study. Cancer Epidemiology, Biomarkers & Prevention. https://doi.org/10.1158/1538-7755.disp24-a036