Improving cervical screening in a remote aboriginal community.

Improved cervical screening has been identified as a priority in reducing the incidence of cervical cancer among Aboriginal women. This paper discusses the cervical screening recommendations of a women's health project developed by Nganampa Health Council (NHC), the Aboriginal-controlled medical service meeting the health needs of the people of the Anangu Pitjantjatjara (AP) Lands. A community participation public health model was used in program development. A process including community and staff consultation, literature review and prioritisation informed the program development, ensuring strategies thereby derived were culturally acceptable as well as practical and scientifically valid. The epidemiology of cervical cancer and screening in this community is discussed. Strategies aimed at maximising patient participation, improving patient satisfaction, running an effective call and recall system, improving quality of cervical smears, improving management of women with abnormal smears and evaluating the program are suggested. The involvement of the community in a scientifically sound, public health approach may increase the likelihood that the strategies suggested will be effective in this community. Both the model of program development and the cervical screening strategies derived are likely to be of relevance for other Aboriginal communities.