Ndakukamo Elizabeth K, Mahalie Roshwitha, Hailonga-van Dijk Panduleni
Department of Preventative Health Sciences, Faculty of Health, Natural Resources and Applied Sciences, Namibia University of Science and Technology (NUST), Windhoek.
Afr J Prim Health Care Fam Med. 2025 Aug 21;17(1):e1-e9. doi: 10.4102/phcfm.v17i1.4976.
Cervical cancer remains a pressing public health concern in Namibia, with significant barriers to prevention, particularly in rural areas.
This study explored health system's challenges and their impact on cervical cancer prevention efforts.
This study was conducted in the Ohangwena and Kavango West regions of Namibia.
A qualitative exploratory design was employed, focusing on healthcare workers directly involved in cervical cancer prevention. In-depth interviews were utilised to collect data from 11 participants from four district hospitals. Thematic analysis, guided by the World Health Organisation's six health system framework pillars, was used.
Key service gaps were identified across critical areas of cervical cancer prevention, including a lack of awareness, a lack of human papillomavirus vaccines and referral screening equipment that limited local outreach services. Other significant findings included the shortage of trained personnel and the manual data systems, which resulted in deficiencies in decision-making. Financial constraints, including reliance on non-governmental organisation funding and weak community engagement, exacerbated by cultural stigma, presented leadership challenges.
Investing in human resources for health, decentralising budget trends and enhancing data systems are critical for cervical cancer prevention in rural Namibia. Equally important is the active involvement of the community in these efforts. Contribution: This study highlights key health system constraints in the Ohangwena and Kavango West regions.
宫颈癌仍是纳米比亚紧迫的公共卫生问题，预防工作面临重大障碍，尤其是在农村地区。
本研究探讨了卫生系统的挑战及其对宫颈癌预防工作的影响。
本研究在纳米比亚的奥汉圭纳和卡万戈西区开展。
采用定性探索性设计，重点关注直接参与宫颈癌预防工作的医护人员。通过深入访谈收集来自四家地区医院的11名参与者的数据。采用由世界卫生组织六个卫生系统框架支柱指导的主题分析法。
在宫颈癌预防的关键领域发现了关键服务差距，包括缺乏认识、缺乏人乳头瘤病毒疫苗以及转诊筛查设备，这限制了当地的外展服务。其他重要发现包括训练有素的人员短缺和手工数据系统，这导致决策存在缺陷。财政限制，包括依赖非政府组织资金以及社区参与薄弱，因文化耻辱感而加剧，带来了领导方面的挑战。
投资于卫生人力资源、分散预算趋势和加强数据系统对于纳米比亚农村地区的宫颈癌预防至关重要。同样重要的是社区积极参与这些工作。贡献：本研究突出了奥汉圭纳和卡万戈西区关键的卫生系统制约因素。
