An exploration of opportunities and challenges facing cervical cancer managers in Kenya

Abstract

BackgroundKenya like other developing countries is low in resource setting and is facing a number of challenges in the management of cervical cancer. This study documents opportunities and challenges encountered in managing cervical cancer from the health care workers’ perspectives. A qualitative study was conducted among cervical cancer managers who were defined as nurses and doctors involved in operational level management of cervical cancer. The respondents were drawn from four provincial hospitals and the only two main National public referral hospitals in Kenya. Twenty one [21] nurse managers and twelve [12] medical doctors were interviewed using a standardized interview guide. The responses were audio recorded, transcribed verbatim and the content analyzed in emerging themes.FindingsFour themes were identified. Patient related challenges included a large number of patients, presenting in the late stage of disease, low levels of knowledge on cancer of the cervix, low levels of screening and a poor attitude towards screening procedure. Individual health care providers identified a lack of specialised training, difficulty in disclosure of diagnosis to patients, a poor attitude towards cervical cancer screening procedure and a poor attitude towards cervical cancer patients. Health facilities were lacking in infrastructure and medical supplies. Some managers felt ill-equipped in technological skills while the majority lacked access to the internet. Mobile phones were identified as having great potential for improving the management of cervical cancer in Kenya.ConclusionKenya faces a myriad of challenges in the management of cervical cancer. The peculiar negative attitude towards screening procedure and the negative attitude of some managers towards cervical cancer patients need urgent attention. The potential use of mobile phones in cervical cancer management should be explored.

Perspectives of Screening-Eligible Women and Male Partners on Benefits of and Barriers to Treatment for Precancerous Lesions and Cervical Cancer in Kenya

“…Findings regarding reported transportation difficulties, long waits, issues with referrals, healthcare workers’ lack of expertise, and shortages of personnel and equipment were consistent with previous studies . One such study supports our findings by reporting that providers are challenged with high patient workload, mismanagement of referrals, and inadequate treatment and inpatient facilities and staff specialized in cancer care, which exacerbate delays in timely treatment and poor patient prognosis .…”

Mind the gaps: a qualitative study of perceptions of healthcare professionals on challenges and proposed remedies for cervical cancer help-seeking in post conflict northern Uganda

“…Abandonment of cervical cancer patients by relatives and poor attitudes of health professionals about cervical cancer patients were also reported by health professionals in Kenya [23]. Public health education programs in communities may need to include accurate information about the causes, symptoms and prognosis of cervical cancer so that the negative attitudes and stigma associated with cervical cancer as well as patient abandonment may be reduced or prevented.…”

Awareness and Self-Perceived Risk of Cervical Cancer among Women Living in Namuwongo, an Informal Settlement in Kampala, Uganda

“…Over, 80% of women with cervical cancer in Uganda are diagnosed with advanced stage disease; thus undermining the benefits expected from available treatment modalities [4,11,12]. A plethora of barriers including limited awareness of cervical cancer symptoms and signs, misattribution of symptoms to other illnesses, poor access to health services, and health professionals' , limitations in diagnosing cervical cancer account in part for advanced stage cervical cancer at diagnosis and poor survival in the LMICs including Uganda [13][14][15][16]. Recent studies in sub Saharan Africa and Uganda, show that women's low self-perceived risk of cervical cancer and improper diagnosis by healthcare professionals in women with symptoms of cervical cancer lead to delayed diagnosis and advanced stages [15,17].…”