Evaluating primary care programmes: a problem-solving cycle with literature review on programme evaluation for cervical cancer screening at a community health centre, Jakarta, Indonesia

Abstract

Background. Cervical cancer (CC) poses a significant burden on various aspects of public health, including overall wellbeing, social dynamics and economic factors. Objectives. This report aimed to evaluate the effectiveness of a primary care programme focused on CC screening through the Visual Inspection with Acetic Acid (VIA) test at a community health centre (CHC) in urban South Jakarta, Indonesia. Material and methods. We used a problem-solving cycle (PSC) approach to evaluate the programme's implementation and outcomes. This evaluation process included problem identification, situation analysis, root-cause determination using the Ishikawa diagram, prioritisation of problem-solving strategies based on the urgency, seriousness and growth (USG) and importance, technical feasibility and resource availability (ITR) matrix, as well as proposing recommendations for improvement using the magnitude, importance, vulnerability and cost (MIV/C) matrix. Results. the low VIA test coverage at our CHC (13.39% in 2020) highlights the need for targeted interventions to increase participation. Inefficient implementation of the programme stems from various reasons (input, process and environmental factors). The solutions target root causes such as material, actuation and community response to improve CC screening. Inadequate knowledge, limited healthcare accessibility and socio-economic disparities hinder programme success. Despite these challenges, programme evaluation can enhance the level of community health, improve the quality of life, increase early CC case detection and reduce morbidity and mortality. Conclusions. This study offers valuable insights and guidance for healthcare professionals in improving primary care programmes for CC screening. Future efforts should focus on addressing barriers and implementing targeted strategies to enhance programme effectiveness and reach.