Women's Autonomy, Community Effort, and Cervical and Breast Cancer Screening Behavior Among Married Women in Nepal

Despite the high prevalence of cervical and breast cancer, screening rates remain low in low-income countries. Using nationally representative data, we examine factors associated with knowledge and uptake of cervical and breast cancer screening among married women ages 30–49 in Nepal. We focus on women's autonomy in health decisions and participation in the Health Mother's Group (HMG), a community group that plays a vital role in improving maternal and child health outcomes. After adjusting for socio-demographic characteristics, we find that those who have autonomy in health decision-making are 5 percentage points (pp) (p-value < 0.05) more likely to have heard about cervical cancer screening (CCS) and 2.3 pp (p-value < 0.1) more likely to get a test. The involvement in HMG is also positively associated with the knowledge as women who have participated in HMG meetings have 13.5 pp (p-value < 0.001) higher chances to know about CCS compared to those who do not have HMG in their village. We find no association between women's autonomy and breast cancer screening (BCS) knowledge or uptake. However, participation in HMG meeting was significantly linked to an increase in BCS knowledge, with a 14.7 pp rise (p-value < 0.001). The findings indicate that women's autonomy is strongly associated with knowledge of CCS, though its link to actual uptake of the screening is only marginal. Participation in HMG meetings is significantly associated with women's knowledge of CCS and BCS, highlighiting the importance of women's attendance and active engagement.