Social determinants of follow-up and treatment of women with abnormal Pap smear. A study in Avellaneda, Buenos Aires province

Abstract

INTRODUCTION: Adequate follow-up and treatment of women with abnormal Pap smear is an important public health concern. OBJECTIVE: This research aimed to describe the determinants of follow-up and treatment of women diagnosed with an abnormal Pap smear. METHODS: A quali-quantitative research was performed. Information sources were medical records and questionnaires administered to women with an abnormal Pap smear that attended public health services, and to health professionals of Avellaneda in Buenos Aires province. RESULTS: Only one woman quit the follow-up and treatment. Almost 50% did not continue treatment at the same health service where they had the first Pap smear; they finished treatment in a public institution in Buenos Aires city or in a social security service. Results showed that both women and health professionals mentioned institutional obstacles, such as long waiting times and cancellation of surgeries. Positive aspects were attributed to a good doctor-patient relationship and to the behavior of professionals who track down women to give them the test results and who use informal networks to shorten waiting times. CONCLUSIONS: Although in this population the above mentioned barriers did not lead to treatment interruption, they proved to be detrimental to the right of women to access health services. Women with precancerous lesions and cancer are in a situation of extreme vulnerability, requiring a special attention and strategies geared to facilitating their passage through the health system.