<p>Barriers and facilitators of follow-up among women with precancerous lesions of the cervix in Cameroon: a qualitative pilot study</p>

Abstract

Purpose This pilot study explores the barriers to adherence to follow-up among women with cervical precancer in urban Cameroon. While follow-up of women with a positive screening of cervical precancer is the most important aspect of cervical cancer secondary prevention, women with cervical precancer do not adhere frequently to recommended follow-up schedule in Cameroon. The aim of the study was to explore and describe the barriers and facilitators to follow-up for cervical precancer among women infected and uninfected with HIV in Cameroon. Participants and methods A qualitative research design was used to answer the research questions. Participants included eight HIV-infected and -uninfected women diagnosed with cervical precancer and 19 nurses. Data were collected by in-depth individual patient interviews and focus groups with nurses. An interview guide with open-ended questions, using the social ecological model as a framework, included questions that addressed the complexities of the lives of individuals and professionals within a relational context. The interviews were audio-taped and transcribed verbatim in English language. Thematic analysis of data was completed with no epistemological or theoretical perspective underpinning the analyses. Results Four major themes emerged from the study. They were clinic, personal, and social barriers, and strategies to improve follow-up. Conclusion The use of reminder phone calls and fee reduction, coupled with peer counseling and navigation of women who have been diagnosed with cervical precancer, could be effective ways of improving adherence to follow-up. Further research is needed to explore the same phenomenon among women in rural areas, especially those who were initially attended to in mobile clinics.

<p>Factors Associated with Treatment Uptake Among Women with Acetic Acid/Lugol’s Iodine Positive Lesions of the Cervix in Cameroon</p>

“…In a recent qualitative study conducted among WHP nurses and clients, payment for treatment was identified as one of the major barriers to same-day treatment and posttreatment follow-up. 14 In a "see and treat" program in Thailand, 98.5% (609/618) of the women with precancer received same-day treatment. 15 However, in this Thailand study, it is not clear whether the treatment was provided at no charge or the women had to pay for it.…”

Scaling up cervical cancer prevention in Western Kenya: Treatment access following a community‐based HPV testing approach

“…Several studies have evaluated barriers to treatment uptake after screening for cervical cancer. A study in Cameroon found that the use of reminder phone calls coupled with peer counseling and navigation of women diagnosed with cervical precancer could be effective ways of improving adherence to follow‐up 22. The role of patient navigators in improving linkage to treatment after screening for cervical cancer has been highlighted in Tanzania 23,24…”

“A loving man has a very huge responsibility”: A mixed methods study of Malawian men’s knowledge and beliefs about cervical cancer

“…The literature on determinants of screening uptake in lower-resource settings has identified important factors including women's cervical cancer knowledge, perceived efficacy of screening, and beliefs about disease severity and susceptibility [13][14][15][16][17][18]. Women have also reported that their male partners influence cervical cancer screening decisions [13,[18][19][20][21][22][23][24], and the World Health Organization recommends male-targeted outreach as a way to increase cervical cancer screening uptake [25] however very little is known about men's perspectives on cervical cancer and screening approaches [26]. The limited literature on this topic indicates that men are not very knowledgeable about cervical cancer (including risk factors, symptoms and ways of screening or treating), and that despite general support for the concept of cancer prevention, some men have hesitations about their wives undergoing screening [27][28][29][30][31][32][33][34][35][36][37][38].…”