Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study

Abstract

Background:In Malawi, cervical cancer is the most prevalent form of cancer among women, with an 80% mortality rate. The Mulanje Mission Hospital has offered free cervical cancer screening for eight years; however, patients primarily seek medical help for gynecologic complaints after the disease is inoperable.Methods:We investigated how women in rural Malawi make health-seeking decisions regarding cervical cancer screening using qualitative research methods. The study was conducted between May and August of 2009 in Mulanje, Malawi.Results:This study found that the primary cue to action for cervical cancer screening was symptoms of cervical cancer. Major barriers to seeking preventative screening included low knowledge levels, low perceived susceptibility and low perceived benefits from the service. Study participants did not view cervical cancer screening as critical health care. Interviews suggested that use of the service could increase if women are recruited while visiting the hospital for a different service.Conclusion:This study recommends that health care providers and health educators target aspects of perceived susceptibility among their patients, including knowledge levels and personal risk assessment. We believe that continued support and advertisement of cervical cancer screening programs along with innovative recruitment strategies will increase usage density and decrease unnecessary deaths from cervical cancer in Malawi.

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

“…High Coverage of the target population by screening test and treatment of all women with abnormal lesions represent the most important factors in determining program success, and are the immense practical challenges (Wongwatcharanukul et al, 2014). Challenges faced by the patients and health care providers in cervical cancer issue can be affected early detection practices (Fort et al, 2011).…”

Women’s Views on Knowledge and Barriers to Cervical Cancer Screening among Women in Kaduna State, Nigeria

“…This is contrary to a study by Ojiyi and Dike (2008), where the most frequent reason given for not using Pap smear services was lack of physician referral. A qualitative study by Fort, Makin and Siegler (2011) among women in rural Malawi on how they make health-seeking decisions regarding cervical cancer screening revealed that, the major barrier to seeking preventive screening was low knowledge level. This lack of knowledge is contrary to studies by Ajah, Iyoke, Ezeonu, Ugwu, Onoh and Ibo (2015) among 412 secondary school teachers at Abakaliki, Nigeria who found that 75% of respondents were aware of at least one method of cervical cancer prevention.…”

Patient Preferences and Willingness to Pay for Cervical Cancer Prevention in Zambia: Protocol for a Multi-Cohort Discrete Choice Experiment (Preprint)

“…For example, Malawi attempted a nationwide cytology-based cervical cancer screening program, but it quickly deteriorated due to lack of resources, trained professionals, and infrastructure. [13] There is therefore an urgent need to implement low-cost approaches already available for prevention and early detection of cervical cancer in Sub-Saharan Africa. No study to date, though, has systematically evaluated preferences for prevention and screening, and this information is required to design and implement programs that will result in optimal uptake.…”