@article {O{\textquoteright}Donovane001452, author = {James O{\textquoteright}Donovan and Charles O{\textquoteright}Donovan and Shobhana Nagraj}, title = {The role of community health workers in cervical cancer screening in low-income and middle-income countries: a systematic scoping review of the literature}, volume = {4}, number = {3}, elocation-id = {e001452}, year = {2019}, doi = {10.1136/bmjgh-2019-001452}, publisher = {BMJ Specialist Journals}, abstract = {Introduction Community-based screening for cervical cancer and task sharing to community health workers (CHWs) have been suggested as a potential way to increase screening coverage in low- and middle-income countries (LMICs). The aims of the scoping review were to understand the following: (i) where and how CHWs are currently deployed in screening in LMIC settings; (ii) the methods used to train and support CHWs in screening, and (iii) The evidence on the cost-effectiveness of using CHWs to assist in screening.Methods A scoping literature search of 11 major databases and the grey literature was performed between 1978 and 2018. We included comprehensive search terms for {\textquoteleft}CHWs{\textquoteright} and {\textquoteleft}Cervical Cancer{\textquoteright}, and used the World Bank criteria to define LMICs.Results Of the 420 articles screened, 15 met the inclusion criteria for review. Studies were located in Africa (n=5), Asia (n=5), and South and Central America (n=5). CHWs played a role in community education and raising awareness (n=14), conducting or assisting in cervical screening (n=5), or follow-up (n=1). 11 studies described CHW training activities. Only one study provided a formal cost analysis.Conclusion The roles of CHWs in cervical cancer screening in LMICs have largely to date focused on education, outreach, and awareness programmes. Community-based approaches to cervical cancer screening are feasible, although the sociocultural context plays an important role in the acceptability of these interventions. Further in-depth contextually grounded studies exploring the acceptability of such interventions are required, as well as studies exploring the cost-effectiveness of involving CHWs in cervical cancer screening activities.}, URL = {https://gh.bmj.com/content/4/3/e001452}, eprint = {https://gh.bmj.com/content/4/3/e001452.full.pdf}, journal = {BMJ Global Health} }