Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context
Background Cervical cancer is a leading cause of death among Cameroon women. The burden of cervical cancer is in part traceable to the inadequate understanding of contextual determinants of access to expanding screening and prevention opportunities. We explored multilevel individual, community and structural factors that facilitate or inhibit cervical cancer prevention in women at risk in a high HIV prevalence context.
Methods We utilized an exploratory qualitative approach to obtain data through focus group discussions and in-depth interviews from May to August, 2018. A two-stage systematic sampling strategy was used to select 80 women and 20 men who participated in 8 focus group discussions and 8 in-depth interviews. The socio-ecological model guided data analyses to identify micro-, meso-, and macro-level determinants of cervical cancer screening.
Results Micro-level factors including lack of awareness and knowledge about cervical cancer, lack of access to information on and excessive costs for cervical cancer screening, low risk perceptions, and poor health seeking behaviors were major barriers for women seeking cervical cancer screening. Meso-level factors, such as social networks, socio-cultural norms, perceptions of the role of men and HIV-related stigma when screening is integrated into HIV care, also engender negative attitudes and behaviors. Macro-level barriers to cervical cancer screening included poorly equipped health facilities and a lack of national cancer prevention policies and programs.
Conclusion In the context of the call for elimination of cervical cancer as a public health problem, our findings highlight challenges and opportunities that should be considered when implementing interventions to increase uptake of cervical cancer screening in low-middle income settings.
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Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context
Posted 14 Jan, 2021
On 18 Feb, 2021
On 21 Jan, 2021
Received 18 Jan, 2021
Invitations sent on 10 Jan, 2021
On 10 Jan, 2021
On 03 Jan, 2021
On 03 Jan, 2021
On 03 Jan, 2021
On 20 Dec, 2020
Received 15 Dec, 2020
On 07 Dec, 2020
Received 28 Nov, 2020
On 10 Nov, 2020
Invitations sent on 24 Apr, 2020
On 16 Apr, 2020
On 15 Apr, 2020
On 15 Apr, 2020
On 08 Apr, 2020
Received 16 Mar, 2020
On 01 Mar, 2020
Invitations sent on 26 Jan, 2020
On 09 Jan, 2020
On 09 Jan, 2020
On 09 Jan, 2020
On 31 Dec, 2019
Background Cervical cancer is a leading cause of death among Cameroon women. The burden of cervical cancer is in part traceable to the inadequate understanding of contextual determinants of access to expanding screening and prevention opportunities. We explored multilevel individual, community and structural factors that facilitate or inhibit cervical cancer prevention in women at risk in a high HIV prevalence context.
Methods We utilized an exploratory qualitative approach to obtain data through focus group discussions and in-depth interviews from May to August, 2018. A two-stage systematic sampling strategy was used to select 80 women and 20 men who participated in 8 focus group discussions and 8 in-depth interviews. The socio-ecological model guided data analyses to identify micro-, meso-, and macro-level determinants of cervical cancer screening.
Results Micro-level factors including lack of awareness and knowledge about cervical cancer, lack of access to information on and excessive costs for cervical cancer screening, low risk perceptions, and poor health seeking behaviors were major barriers for women seeking cervical cancer screening. Meso-level factors, such as social networks, socio-cultural norms, perceptions of the role of men and HIV-related stigma when screening is integrated into HIV care, also engender negative attitudes and behaviors. Macro-level barriers to cervical cancer screening included poorly equipped health facilities and a lack of national cancer prevention policies and programs.
Conclusion In the context of the call for elimination of cervical cancer as a public health problem, our findings highlight challenges and opportunities that should be considered when implementing interventions to increase uptake of cervical cancer screening in low-middle income settings.