Mantula Fennie, Toefy Yoesrie, Sewram Vikash
Department of Nursing and Midwifery, Faculty of Medicine, National University of Science and Technology, Bulawayo, Zimbabwe.
African Cancer Institute, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
BMC Public Health. 2025 Jan 20;25(1):235. doi: 10.1186/s12889-025-21373-8.
Numerous studies have been conducted on barriers to cervical cancer screening in low resourced settings. Few have however explored the factors that motivate women to make the decision for screening. This study therefore aimed at identifying strategies that could strengthen the utilisation of screening services, with the goal of informing the development of context for enhancing cervical cancer programmes in Gwanda district, Zimbabwe. The socio-ecological model that implies individual, inter-personal, community, and health system factors as influencers of screening behaviours guided the study.
A cross sectional qualitative design using five focus group discussions with 36 screening-eligible women aged 25-50 years, and 25 in-depth interviews of health providers with varied responsibilities in the screening programme were conducted. Data were analysed thematically with the aid of the Web Atlas.ti software.
Key findings suggest that women's willingness to be screened, on-going awareness campaigns and an increasing number of screening sites and nurses trained in screening procedures promote the uptake of screening. Concomitantly, awareness and knowledge about cervical cancer screening, male support, and community involvement in planning and implementation of programmes were seen as facilitators to screening, with accessibility of cervical cancer screening services being recognised as the most important.
To exploit on women's willingness to be screened, delivery of screening services need to be re-engineered through development of strategies for increased and sustained educational programmes and increase of screening facilities. This could effectively address the prevalent barriers and enhance the facilitators for screening uptake.
针对资源匮乏地区宫颈癌筛查的障碍，已经开展了大量研究。然而，很少有研究探讨促使女性做出筛查决定的因素。因此，本研究旨在确定能够加强筛查服务利用的策略，以便为津巴布韦万德区加强宫颈癌防治项目提供背景信息。本研究以社会生态模型为指导，该模型认为个人、人际、社区和卫生系统因素会影响筛查行为。
采用横断面定性设计，与36名年龄在25至50岁、符合筛查条件的女性进行了五次焦点小组讨论，并对在筛查项目中承担不同职责的25名卫生服务提供者进行了深入访谈。借助Web Atlas.ti软件对数据进行了主题分析。
主要研究结果表明，女性接受筛查的意愿、持续开展的宣传活动、筛查点数量的增加以及接受过筛查程序培训的护士数量的增加，都促进了筛查的接受率。同时，对宫颈癌筛查的认识和了解、男性的支持以及社区参与项目的规划和实施，都被视为筛查的促进因素，其中宫颈癌筛查服务的可及性被认为是最重要的。
为了利用女性接受筛查的意愿，需要通过制定增加和持续开展教育项目的策略以及增加筛查设施，对筛查服务的提供进行重新设计。这可以有效解决普遍存在的障碍，增强促进筛查接受率的因素。
