'We do the impossible': women overcoming barriers to cervical cancer screening in rural Honduras--a positive deviance analysis

Cult Health Sex. 2013;15(6):637-51. doi: 10.1080/13691058.2012.760206. Epub 2013 Feb 13.


Cervical cancer is the leading cause of cancer death for women in Honduras, and sexual behaviour and low screening uptake are two major factors contributing to high rates of morbidity and mortality. A qualitative study was conducted to investigate barriers that prevent rural Honduran women from engaging in screening and ways that women overcome those barriers. This study examined examples of positive deviance, or individuals engaging in the uncommon but beneficial practise of screening. Amor por sí misma (self-love), and social support were identified as two constructs women employed to overcome barriers to screening. Participants defined self-love as the act of displaying care and concern for oneself and one's health and suggested that it compels women to participate in screening. Social support was defined as receiving tangible aid and advice from others that facilitated women's screening participation. Findings suggest that the concept of self-love could be used in future screening promotion efforts and that integrating social support would also be beneficial. Engaging men in sexual and reproductive health programming is suggested in order to ensure male partners offer social support for screening and to challenge the cultural, gender and sexual norms that place women at higher risk for cervical cancer.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Culture
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice*
  • Honduras
  • Humans
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Qualitative Research
  • Reproductive Health Services / statistics & numerical data
  • Rural Population
  • Social Support
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / epidemiology