Abstract
BackgroundThe second most common cancer among females in Bangladesh is cervical cancer. The national strategy for cervical cancer needs monitoring to ensure that patients have access to care. In order to provide accurate information to policymakers in Bangladesh and other low and middle income countries, it is vital to assess current service availability and readiness to manage cervical cancer at health facilities in Bangladesh.MethodsAn interviewer-administered questionnaire adapted from the World Health Organization Service Availability and Readiness Assessment Standard Tool was used to collect cross-sectional data from health administrators of 323 health facilities in Bangladesh. Services provided were categorized into domains and service readiness was determined by mean readiness index (RI) scores. Data analysis was conducted using STATA version 13.ResultsThere were seven tertiary and specialized hospitals, 118 secondary level health facilities, 124 primary level health facilities, and 74 NGO/private hospitals included in the study. Twenty-six per cent of the health facilities provided services to cancer patients. Among the 34 tracer items used to assess cancer management capacity of health facilities, four cervical cancer-specific tracer items were used to determine service readiness for cervical cancer. On average, tertiary and specialized hospitals surpassed the readiness index cutoff of 70% with adequate staff and training (100%), equipment (100%), and diagnostic facilities (85.7%), indicating that they were ready to manage cervical cancer. The mean RI scores for the rest of the health facilities were below the cutoff value, meaning that they were not prepared to provide adequate cervical cancer services.ConclusionThe health facilities in Bangladesh (except for some tertiary hospitals) lack readiness in cervical cancer management in terms of guidelines on diagnosis and treatment, training of staff, and shortage of equipment. Given that cervical cancer accounts for more than one-fourth of all female cancers in Bangladesh, management of cervical cancer needs to be available at all levels of health facilities, with primary level facilities focusing on early diagnosis. It is recommended that appropriate standard operating procedures on cervical cancer be developed for each level of health facilities to contribute towards attaining sustainable developmental goals.
Highlights
The second most common cancer among females in Bangladesh is cervical cancer
Studies show that about 80% of deaths due to Noncommunicable disease (NCD) occur in low- and middle-income countries (LMICs) [3]
The study findings suggest that health facilities in Bangladesh lack readiness in cervical cancer management in terms of guidelines on diagnosis and treatment, staff training, and shortage of equipment
Summary
The second most common cancer among females in Bangladesh is cervical cancer. The national strategy for cervical cancer needs monitoring to ensure that patients have access to care. In order to provide accurate information to policymakers in Bangladesh and other low and middle income countries, it is vital to assess current service availability and readiness to manage cervical cancer at health facilities in Bangladesh. The increasing burden of noncommunicable diseases (NCDs), such as diabetes, hypertension, cardiovascular diseases, and cancer has become a significant global public health concern [1, 2]. Studies show that about 80% of deaths due to NCDs occur in low- and middle-income countries (LMICs) [3]. In 2018, 9.6 million global deaths were due to cancer, making it the second leading cause of death, of which approximately 70% occurred in LMICs [5, 6]. 26% of people in LMICs have access to diagnostic services for cancer [6]. Colorectum and breast (in females) cancers are the most frequently occurring cancers globally [6]
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