Challenges of Providing Cervical Cancer Prevention Programs In Iran: A Qualitative Study

Abstract

Background: Cervical cancer has become a major public health problem worldwide. Iran, like other developing countries, is facing a number of challenges in managing the disease. This qualitative study documents challenges encountered in cervical cancer preventing programs in Iran. Materials and Methods: In-depth interviews were conducted with 28 participants including eleven patients with cervical cancer, three gynecologic oncologists, five specialists in Obstetrics and Gynecology, five midwives, three health care managers and one epidemiologist in Mashhad Iran, between May and December of 2012. The sample was selected purposively until data saturation was achieved. Data credibility verified via allocated sufficient time for data collection, using member checking and peer debriefing. Data analysis was carried out using conventional content analysis approach with ATLAS. ti software. Results: Findings from data analysis demonstrated 2 major themes and 6 categories about challenges of providing cervical cancer prevention programs including: individual and social challenges (cognitive/behavioral challenges and socio/cultural challenges) and health system challenges (stewardship, financing, competency of health care providers and access to services). Each category included some subcategories. Conclusions: Managing the cervical cancer prevention programs need to include the consideration of individuals, health care providers and health system challenges. Addressing the low level of knowledge, negative attitudes, socio cultural challenges, Poor intersectional collaboration and coordination and intra-sectional management, financing and competency of health care providers are essential steps toward significantly reducing the burdens of cervical cancer.

Low level of awareness among Iranian women concerning cervical cancer and screening: the role of knowledge, risk perceptions and cues to action

“…Thirdly, with regard to cues to action, our respondents disliked discussing and thinking about cervical cancer and their existing symptoms, due to local beliefs about the consequences of such thinking and discussions, a finding reported in other studies (24,27,52,59). Consequently, receiving a cue to act as a result of discussions with others is rare in Iran.…”

“…Several factors have been found to be associated with low attendance of cervical cancer screening in various countries. Some of these pertain to socio-demographic factors, such as access to services and financial issues (24,25), lack of advice from a health care provider (HCP) (20,25,26), and social and cultural barriers (24,27,28). Others are related to women's knowledge regarding the existence of HPV infection-and cervical cancer screening programs (26,(29)(30)(31)(32), factors influencing the awareness of the need to be screened (33,34), misconceptions about suseptibility to CC (34), and contextual cues such as cancer in the family (20).…”

The role of knowledge, risk perceptions and cues to action among Iranian women concerning cervical cancer and screening: A qualitative exploration

“…Thirdly, with regard to cues to action, our respondents disliked discussing and thinking about cervical cancer and their existing symptoms, due to local beliefs about the consequences of such thinking and discussions, a nding reported in other studies (24,27,53,60). Consequently, receiving a cue to act as a result of discussions with others is rare in Iran.…”

Association of Educational Levels with Survival in Indian Patients with Cancer of the Uterine Cervix

“…Our stage correlation has shown that early staged cancers of the uterine cervix are more likely to be detected in educated patients irrespective of their levels of educational qualification. Low level of knowledge in females poses a challenge in prevention strategies for uterine cervix cancer (Bayrami et al, 2014). There might be associated sociodemographic contributing factors like compliance and adherence to treatment protocol, personal hygiene and self care, nutritional status etc in the improvement of median and overall survival in patients with higher educational qualifications in our population, which warrants further investigation.…”