Abstract
Cervical cancer poses a significant global health threat, necessitating proactive measures for early detection and intervention. In the context of Nuwara Eliya, Sri Lanka, where Pap smear screening coverage stands at a mere 6%, well below the World Health Organization's recommended 80% threshold, this research embarks on a comprehensive exploration of the barriers hindering participation. Through a descriptive cross-sectional study involving 362 women aged 35-50 years, coupled with qualitative interviews with key stakeholders, the study illuminates a myriad of challenges. Furthermore, a striking lack of awareness regarding cervical cancer prevention and the significance of Pap smear screenings comes to the fore. Accessibility issues, particularly in remote areas with scant screening facilities, emerge as critical barriers. Qualitative insights from Public Health Midwives reveal resource constraints and the urgent need for specialized training. In light of these findings, the study advocates for evidence-based policy interventions. Targeted strategies are proposed to address cultural sensitivities, enhance awareness through tailored campaigns, and ensure equitable access to screening services and to development of comprehensive and region-specific policies aimed at boosting Pap smear screening participation in Nuwara Eliya, Sri Lanka.