Kedar Ashwini, John Amrita, Goala Subhadra, Babu Roshni, Tapkire Ritesh, Kannan Ravi, Hariprasad Roopa
National Viral Hepatitis Control Program, Ministry of Health and Family Welfare, Nirman Bhawan, Delhi 110001, India.
Guntherstrase, 34, Duisburg, North Rhine Westphalia, 47051, Germany.
Ecancermedicalscience. 2021 Aug 19;15:1277. doi: 10.3332/ecancer.2021.1277. eCollection 2021.
Population based cancer screening was initiated in India in 2016 owing to an increased burden of cancers. A feasibility health system study was done by utilising community health workers (CHWs) to conduct the cancer screening. The current study is a qualitative study to elicit the barriers and facilitators in implementing population based cancer screening through CHWs. The study was conducted at three subcentres of Dholai block of Cachar district, Assam, India and Cachar Cancer Hospital and Research Center, Silchar. The participants of the study were CHWs, master trainer nurses and women from community. Three focus group discussions (FGDs) and one in-depth interview (IDI) were conducted at the provider level and seven IDIs of women from the community. The FGDs and IDIs were audio recorded after taking verbal consent from the participants. The verbatims were prepared following translation and transcription and data analysis using ATLAS ti ver 8. The major barrier faced by the community was a lack of motivation to get screened which stemmed from various factors such as personal beliefs, attitudes and fear. The major facilitators were accessibility of tests, family support and CHWs as screening service providers. The major barriers for CHWs were difficulty in motivating the community, lack of support from supervisors and lack of motivation to work. The major facilitators were convenience of screening during home visits, empowerment, skill enhancement and teamwork. Population based cancer screening was a new concept for the community under study. Cancer screening by CHWs was well accepted by the community. Awareness generation among the community was a major factor in improving screening coverage. The study highlights that training and motivation of CHWs can improve the uptake of cancer screening services. CHWs felt empowered with the new skills imparted and were able to carry out screening.
由于癌症负担加重，印度于2016年启动了基于人群的癌症筛查。通过利用社区卫生工作者（CHWs）开展癌症筛查进行了一项可行性卫生系统研究。本研究是一项定性研究，旨在找出通过社区卫生工作者实施基于人群的癌症筛查中的障碍和促进因素。该研究在印度阿萨姆邦卡恰尔区多拉伊街区的三个基层医疗中心以及锡尔恰尔的卡恰尔癌症医院和研究中心进行。研究参与者包括社区卫生工作者、培训师护士和社区女性。在提供者层面进行了三次焦点小组讨论（FGDs）和一次深入访谈（IDI），并对七名社区女性进行了深入访谈。在获得参与者口头同意后，对焦点小组讨论和深入访谈进行了录音。逐字记录在翻译、转录后使用ATLAS ti 8.0版本进行数据分析。社区面临的主要障碍是缺乏接受筛查的动力，这源于个人信仰、态度和恐惧等各种因素。主要促进因素是检测的可及性、家庭支持以及作为筛查服务提供者的社区卫生工作者。社区卫生工作者面临的主要障碍是难以激励社区、缺乏上级支持以及工作动力不足。主要促进因素是家访期间筛查的便利性、赋权、技能提升和团队合作。基于人群的癌症筛查对所研究的社区来说是一个新概念。社区卫生工作者进行的癌症筛查得到了社区的广泛接受。在社区中提高认识是提高筛查覆盖率的一个主要因素。该研究强调，对社区卫生工作者的培训和激励可以提高癌症筛查服务的接受率。社区卫生工作者因获得新技能而感到有能力，并能够开展筛查工作。
