Date of Conferral





Public Health


Richard Palmer


Although Grenada has an extensive health care infrastructure and cervical cancer screening rates are relatively high, Grenada also has a disproportionate rate of morbidity and mortality from cervical cancer. The aim of this study was to explore factors that contribute to these disproportionate rates in Grenada. Using a phenomenological qualitative approach, Andersen's behavioral model of health care utilization and a systems based model for assessing care were used as a guide to explore Grenadian women's follow-up experiences with Pap test and cervical cancer screening. Purposive sampling was used to recruit 8 women for semi-structured in-depth interviews. Data were collected on enabling, need, process and quality factors and coded using apriori and open strategies. Results showed that communication strategies used by private practitioners and good interpersonal relationships with nurses enabled follow-up whereas inadequate treatment services, delays in the receipt of test results, and lack of trust in the government clinics were hindrances. This research identified gaps in the follow-up system and is, therefore, significant for the Grenada Ministry of Health to inform planning and restructuring in order to increase system effectiveness. Implications of positive social change include broadening the knowledge base and skill sets of nurses, highlighting strengths of the public system, and identifying target areas for resource allocation. These changes can result in increased workforce efficiency, improved accessibility and quality, a more user-friendly follow-up process and, thus, reduced morbidity and mortality from cervical cancer.