A Narrative Review on Bridging the Gap in Women’s Health: Self-Help Group versus Accredited Social Health Activist-led Cervical Cancer Screening Strategies in India

Cervical cancer has continued to be a major public health menace and the leading cause of deaths resulting from cancer among women Low and Middle-Income Countries (LMIC) particularly in India. There are very effective screening methods that include Pap smears and Visual Inspection with Acetic acid (VIA), but cervical cancer screening coverage rates remain at appallingly low levels due to a combination of sociocultural and systemic barriers. The population has inadequate information, suffers from stigmatisation, lacks easy access to healthcare facilities, and does not seek treatment; hence late diagnosis leads to high mortality rates. Community-based strategies have been able to effectively sensitise people and facilitate their screening uptake. Two such grassroots approaches that this paper will attempt to review and comparatively analyse are Self-Help Group (SHG)-based interventions and Accredited Social Health Activist (ASHA)-led awareness drives. ASHA workers are health facilitators appointed by the government, who help greatly with the mobilisation of women and establishment of linkages with the healthcare services whereas in the SHG-based model, peer influence, group dynamics, and participatory learning create behaviour change in a community. Through a synthesis of recent studies and evaluations of programs, the present article rates the relative efficacy, reach, acceptability, and sustainability of both models. Results indicate that though ASHA-led efforts might be critical due to their existence within the healthcare system, SHG-based intervention has a higher possibility of creating long-term impact because of peer trust, empowerment, and community ownership. A hybrid model integrating both strategies can be proposed as a pathway that would work synergistically toward improving coverage for cervical cancer screening in varied Indian settings.