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

  • Bayrami, Roghieh (Nursing and Midwifery School, student research committee, School of Health, Mashhad University of Medical Sciences) ;
  • Taghipour, Ali (Health Sciences Research Center, Department of Biostatistics, School of Health, Mashhad University of Medical Sciences) ;
  • Ebrahimipour, Hossein (Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences)
  • Published : 2015.01.06

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.

Keywords

Cervical cancer;health systems plans;Pap smear test;qualitative research;Iran

Acknowledgement

Supported by : Mashhad University of Medical Sciences

References

  1. Al-Meer F, Aseel M, Al-Khalaf J, Al-Kuwari M, Ismail M (2011). Knowledge, attitude and practices regarding cervical cancer and screening among women visiting primary health care in Qatar. Eastern Mediterranean Health Journal, 17, 855-61.
  2. Arrossi S, Paolino M, Sankaranarayanan R (2010). Challenges faced by cervical cancer prevention programs in developing countries: a situational analysis of program organization in Argentina. Revista Panamericana Salud Publica, 28, 249-57.
  3. Binagwaho A, Ngabo F, Wagner CM, et al(2013). Integration of comprehensive women's health programmes into health systems: cervical cancer prevention, care and control in Rwanda. Bull WHO, 91, 697-703.
  4. Birhanu Z, Abdissa A, Belachew T, et al (2012). Health seeking behavior for cervical cancer in Ethiopia: a qualitative study. Int J Equity Health, 11, 83-90. https://doi.org/10.1186/1475-9276-11-83
  5. Budkaew J, Chumworathayi B (2014). Factors associated with decisions to attend cervical cancer screening among women aged 30-60 years in Chatapadung contracting medical unit, Thailand. Asian Pac J Cancer Prev, 15, 4903-7. https://doi.org/10.7314/APJCP.2014.15.12.4903
  6. Cavalli F (2006). Cancer in the developing world: can we avoid the disaster? Nature Clinical Practice Oncology, 3, 582-3.
  7. Chen L, Evans T, Anand S, et al(2004). Human resources for health: overcoming the crisis. Lancet, 364, 1984-90. https://doi.org/10.1016/S0140-6736(04)17482-5
  8. Eghbali SS, Amirinejad R, Obeidi N, et al (2012). Oncogenic human papillomavirus genital infection in southern Iranian women: population-based study versus clinic-based data. Virology J, 9, 1-6. https://doi.org/10.1186/1743-422X-9-1
  9. Esmailpour N, Mirblouk F, Shodjaei Tehrani H, Poorseyad Reza A, Dalil Heirati S (2011). Survey the knowledge, attitude and practice on popsmear in nurses and midwives. J Gilan Univ Medical Sciences, 19, 81-8.
  10. Fort VK, Makin MS, Siegler AJ, Ault K, Rochat R (2011). Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study. Patient Preference Adherence, 5, 125-131.
  11. Hadi N, Azimirad A(2012). Knowledge attitude and practice of women in shiraz about cervical cancer and Pap Smear. Iranian J Cancer Prev, 3, 117-26.
  12. Haghshenas M, Golini-moghaddam T, Rafiei A, et al (2013). Prevalence and type distribution of high-risk human papillomavirus in patients with cervical cancer: a populationbased study. Infectious Agents Cancer, 8, 20-25. https://doi.org/10.1186/1750-9378-8-20
  13. Hanley SJB, Yoshioka E, Ito Y, et al (2014). An exploratory study of Japanese fathers' knowledge of and attitudes towards HPV and HPV vaccination: does marital status matter? Asian Pac J Cancer Prev, 15, 1837-43. https://doi.org/10.7314/APJCP.2014.15.4.1837
  14. International Agency for Research on Cancer (2012). Estimated incidence, mortality and prevalence worldwide in 2012. Available at: http:// globocan.iarc.fr. Accessed on 2014 march,1.
  15. Jalilian F, Emdadi S (2011). Factors related to regular undergoing Pap-smear test: application of theory of planned behavior. J Res Health Sciences, 11, 103-8.
  16. Karimi M, Shamsi M, Araban M, Gholamnia Z, Kasmai P (2012). Health beliefs and performance regarding Pap Smear test in zarandieh city women's. J Guilan Univ Medical Sciences, 20, 42-8.
  17. Kawonga M, Fonn S (2008). Achieving effective cervical screening coverage in South Africa through human resources and health systems development. Reprod Health Matters, 16, 32-40. https://doi.org/10.1016/S0968-8080(08)32403-3
  18. Kaya M, Akin A (2009). Cervical cancer and public health approaches. HUKSAM Publication Ankara. p.1-60
  19. Khan G, Naeem H, Khan S, et al (2014). Understanding and responsiveness level about cervical cancer and its avoidance among young women of Pakistan. Asian Pac J Cancer Prev, 15, 4877-83. https://doi.org/10.7314/APJCP.2014.15.12.4877
  20. Kivuti-Bitok LW, Pokhariyal GP, Abdul R, McDonnell G (2013). An exploration of opportunities and challenges facing cervical cancer managers in Kenya. BMC Res Notes, 6, 136-145. https://doi.org/10.1186/1756-0500-6-136
  21. Murillo R, Almonte M, Pereira A, et al (2008). Cervical cancer screening programs in Latin America and the Caribbean. Vaccine, 26, 37-48. https://doi.org/10.1016/j.vaccine.2008.06.013
  22. Polit D, Beck C, Hungler B (2006). Essentials of Nursing Research, Methods, Appraisal and Utilization. Lippincott Williams & Wilkins, Philadelphia, 11-23.
  23. Reis N, Bebis H, Kose S, et al (2012). Knowledge, behavior and beliefs related to cervical cancer and screening among Turkish women.? Asian Pac J Cancer Prev, 13, 1463-70. https://doi.org/10.7314/APJCP.2012.13.4.1463
  24. Saberi f, Sadat Z, Abedzadeh M (2012). Factors associated with cervical cancer screening and its barriers among women: Kashan, Iran. Payesh, 11, 365-70.
  25. Sano H, Goto R, Hamashima C (2014). What is the most effective strategy for improving the cancer screening rate in Japan? Asian Pac J Cancer Prev, 15, 2607-12. https://doi.org/10.7314/APJCP.2014.15.6.2607
  26. Urasa M, Darj E (2011). Knowledge of cervical cancer and screening practices of nurses at a regional hospital in Tanzania. Afr Health Sci, 11, 48-57.
  27. Vaisy A, Lotfinejad S, Zhian F (2012). Relationship between utrine cervical carcinoma and oral contraceptives. J Gorgan University of Med Sci, 14, 98-103.
  28. World Health Organization (WHO) (2008). Are the number of cancer cases increasing or decreasing in the world? April 2014.
  29. Wongwatcharanukul L, Promthet S, Bradshaw P, Jirapornkul C, Tungsrithong N (2014). Factors affecting cervical cancer screening uptake by hmong hilltribe women in Thailand. Asian Pac J Cancer Prev, 15, 3753-6 https://doi.org/10.7314/APJCP.2014.15.8.3753
  30. Yilmazel G, Duman NB (2014). Knowledge attitudes and beliefs about cervical cancer and human papilloma virus vaccination with related factors in Turkish university students. Asian Pac J Cancer Prev, 15, 3699-704. https://doi.org/10.7314/APJCP.2014.15.8.3699
  31. Zareai M (2014). Women's knowledge and practice about pap smear test and it's barriers in Jahrom city. Jahrom Medical Journal, 12, 16-21.

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