Abstract
BackgroundThere are limited data on perceptions of health professionals on challenges faced by cervical cancer patients seeking healthcare in the developing countries. We explored the views of operational level health professionals on perceived barriers to cervical screening and early help–seeking for symptomatic cervical cancer and the proposed remedies to the challenges.MethodsFifteen key informant interviews were held with health professionals including medical directors, gynecologists, medical officers, nurses and midwives in the gynecology and obstetrics departments of two hospitals in northern Uganda during August 2012 to April 2013. We used content analysis techniques to analyze the data.ResultsHealth professionals’ perceived barriers to cervical cancer care included: (i) patients and community related barriers e.g. lack of awareness on cervical cancer and available services, discomfort with exposure of women’s genitals and perceived pain during pelvic examinations, and men’s lack of emotional support to women (ii) individual healthcare professional’s challenges e.g. inadequate knowledge and skills about cervical cancer management; (iii) health facility related barriers e.g. long distances and lack of transport to cervical cancer screening and care centers, few gynecologists and lack of pathologists, delayed histology results, lack of established palliative care services and inadequate pain control; and (iv) health policy challenges e.g. lack of specialized cancer treatment services, and lack of vaccination for human papilloma virus. Other challenges included increased number of cervical cancer patients and late stage of cervical cancer at presentations.ConclusionsOperational level healthcare professionals in northern Uganda reported several practical challenges facing cervical cancer care that influence their decisions, management goals and practices. The challenges and proposed remedies can inform targeted interventions for early detection, management, and control of cervical cancer in Uganda.
Highlights
There are limited data on perceptions of health professionals on challenges faced by cervical cancer patients seeking healthcare in the developing countries
In this study we explored the perceptions of operational level healthcare professionals who work directly with cervical cancer patients on the challenges faced by women seeking cervical screening, cervical cancer diagnosis and management, and challenges faced by health professionals in providing cervical cancer care
Gulu hospital is a 335 bed capacity public facility [11]. These two hospitals are the main facilities with capacity to diagnose and provide surgical treatment such as hysterectomy for cervical cancer patients in the mid northern region which include Kitgum, Pader, Agago, Lamwo, Amuru, Nwoya, and Oyam districts
Summary
Study setting This study was conducted in St. Mary’s hospital, Lacor and Gulu Regional Referral Hospital in Gulu district, northern Uganda from August 2012 to April 2013. These two hospitals are the main facilities with capacity to diagnose and provide surgical treatment such as hysterectomy for cervical cancer patients in the mid northern region which include Kitgum, Pader, Agago, Lamwo, Amuru, Nwoya, and Oyam districts Both Lacor and Gulu hospitals offer cervical screening services. We purposefully selected the medical directors and other respondents from the gynecology and obstetrics wards and from the cervical screening units of the two hospitals. Data analysis Verbatim transcription of the field notes and audio recordings were immediately done following each interview. Before transitioning to the theme or statement on the study guide, the interviewer read back the summary of the issues that emerged in the preceding section and participants were allowed time to confirm, add or withdraw any aspect of recorded information they felt did not represent what they had said. No participant declined audio recording or participation in the study
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