Healthcare infrastructure and cervical cancer screening in low-resource settings: A systematic review focused on Sub-Saharan Africa

Cervical cancer remains a major public health problem, causing over 340,000 deaths in 2020, with nearly 90% occurring in low- and middle-income countries. Sub-Saharan Africa (SSA) carries the highest burden due to weak health systems, limited HPV vaccination, and very low screening coverage. This review, conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, synthesized evidence from thirty recent studies and found that screening uptake in SSA remains extremely low (10–19%, pooled 12.9%), constrained by limited access to facilities, personnel shortages, inadequate equipment, socioeconomic inequities, weak supply chains, low provider guideline awareness, cultural stigma, and high loss to follow-up. Promising strategies to address these barriers include task-shifting to nurses and community health workers, structured training and supervision, mobile clinics, community outreach, and emerging technologies such as AI-powered diagnostics. With targeted investment, political commitment, and adaptation of proven global strategies, SSA can strengthen screening, improve equity, and move closer to eliminating cervical cancer as a public health threat. • Cervical cancer screening uptake in SSA remains critically low at below 15% • Health system gaps, stigma, and inequities drive low screening coverage • Task-shifting and provider training improve screening access and quality • Mobile clinics and service integration expand reach in underserved areas • System-level investment is key to equitable cervical cancer elimination