Table 3 Client-related factors

Contextual influences (historic, socio-cultural, environmental, health systems, political factors)

∙ Communication and media environment

∙ Influential leaders, lobbies

∙ Historical factors

∙ Religion, culture

∙ Gender issues

∙ Politics

∙ Geographical barriers

∙ Perceptions of technology

Individuals and groups

∙ Personal and family experience with cancer

∙ Beliefs and attitudes regarding screening and prevention

∙ Knowledge and awareness

∙ Trust in health system and providers

∙ Perceived benefits of early treatment

∙ Social norms in the community

Specific issues related to cervical cancer screening

∙ Attitudes towards gynecological examination

∙ Attitudes towards privacy or involvement of male providers

∙ Costs (including indirect costs such as transportation)

∙ Health systems factors (waiting, returning for screening)