In this post, we talk to the authors of the recently published paper Barriers to cervical cancer screening among refugee women: A systematic review by Md Anwer Hossain, Shimlin Jahan Khanam,Md. Nuruzzaman Khan, John Oldroyd, and Rakibul M. Islam
What led you to decide on this research question?
Our team has been involved in research on health disparities among forcibly displaced populations. My previous work on fertility behavior among the Forcibly Displaced Myanmar Nationals (Rohingya) in Bangladesh highlighted how forced migration can reshape women’s health needs and experiences. We noticed that refugee women’s perspectives on cervical cancer screening were often missing in the broader public health conversation. These observations motivated us to focus on the unique barriers refugee women face when it comes to life-saving interventions like cervical cancer screening. We wanted to understand these barriers not just from a health services perspective, but through the women’s own experiences. This study was our way of contributing to a more humane and responsive healthcare system for women displaced by circumstances beyond their control.
Could you talk us through how you designed your study? What was important for your team as you created the study?
We approached this study as a systematic review, but with a deep commitment to reflecting the lived realities of refugee women. We chose a framework synthesis method because refugee populations are so diverse—no single framework could fully capture the social, cultural, and systemic barriers they face. By foregrounding their experiences, we aimed to avoid the common pitfall of relying solely on provider or policy-level perspectives. Because we’re a relatively small, interdisciplinary group, collaboration was key. Team members brought expertise in public health, demography, and fieldwork with refugee communities. This blend of perspectives helped us interpret the data holistically, ensuring we considered cultural, social, and structural factors influencing screening uptake.
What challenges did you encounter during your study?
One major challenge was the fragmented nature of the literature. Many studies lump refugees together with other migrant groups, masking their specific vulnerabilities. Also, refugee women come from highly diverse regions, each with its own cultural, legal, and healthcare dynamics, making synthesis complex. Another challenge was the limited geographic spread—most studies were based in high-income countries, primarily the USA, with little representation from regions where refugee camps and displacement are more common. As a researcher, it was difficult to balance wanting to provide a global view while acknowledging that this review is constrained by what has been studied so far.
What did you find most striking about your results? How will this research be used?
I was struck by the consistent lack of knowledge refugee women had about cervical cancer and its screening—even in countries where these services are widely available. But what stood out most was the long shadow cast by negative experiences in refugee camps, shaping deep mistrust of healthcare systems long after resettlement.
These insights highlight that solving this issue isn’t just about providing services—it’s about rebuilding trust. I hope these findings will inform policies that prioritize culturally sensitive education, ensure the availability of female healthcare providers, and address systemic issues like insurance coverage and transportation barriers. Ultimately, this research is a call to action for those working at the intersection of refugee health and health equity.
What further research questions need to be addressed in this area?
Further research should delve deeper into the realities of refugee women living outside high-income settings. Most studies focus on the U.S. or Europe, but the majority of refugees reside in lower-resource contexts, where barriers to healthcare can be even more pronounced.
We also see a need for implementation studies that test what works best—whether that’s using community health workers, mobile clinics, or other creative approaches—to boost screening rates. Understanding how factors like age, literacy, and marital status intersect with displacement experiences could help tailor interventions to diverse groups of refugee women.
Why did you choose PLOS Global Public Health as a venue for your article?
PLOS Global Public Health stands out for its commitment to equity and to research that serves underrepresented populations globally. We wanted this work to be openly accessible to researchers, NGOs, and practitioners working in both high-resource and fragile settings. The journal’s global readership, paired with its emphasis on dismantling health inequities, made it a natural home for this paper. We hope this work will spark greater awareness and collaboration to improve health outcomes for one of the world’s most vulnerable populations.