Barriers to cervical cancer prevention in rural Cameroon: a qualitative study on healthcare providers' perspective

Article Article scientifique Article Barriers to cervical cancer prevention in rural Cameroon: a qualitative study on healthcare providers' perspective eng 2021-06-17 2021-06-17 author Roux Amandine Noémie 0000-0002-2632-8720 Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland amandine.roux.bores@gmail.com. 838468 author Kenfack Bruno Mother and Child Unit, Dschang District Hospital, Dschang, Cameroon. author Ndjalla Alexandre Mother and Child Unit, Dschang District Hospital, Dschang, Cameroon. author Sormani Jessica 0000-0001-7111-3975 Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland. 689966 author Wisniak Ania 0000-0002-3942-2134 Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland. 717179 ania Wisniak author Tatrai Karolin Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland. 818653 author Vassilakos Pierre Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.,Geneva Foundation for Medical Education and Research, Geneva, Switzerland. 25351 author Petignat Patrick Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland. 586685 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Schmidt Nicole Christine Gynecology Division, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Social Science, Catholic University of Applied Sciences, Munich, Germany. 558025 e043637 10.1136/bmjopen-2020-043637 34140340 2044-6055 PMC8212185 https://bmjopen.bmj.com/content/11/6/e043637 Objective: Cervical cancer in Cameroon ranks as the second most frequent cancer among women and the leading cause of cancer-related deaths, mainly due to the lack of prevention. Our principal objective was to explore potential barriers to an human papillomavirus (HPV)-based cervical cancer screening from a healthcare provider (HCP) perspective in a low-income context. Second, we aimed to explore the acceptability of a single-visit approach using HPV self-sampling. Settings: The study took place in the District hospital of Dschang, Cameroon. Participants: Focus groups (FGs) involved HCPs working in the area of Dschang and Mbouda. Primary and secondary outcome measures: All FGs were audiorecorded, transcribed and coded independently by two researchers using the ATLAS.ti software. A qualitative methodology was used to capture insights related to the way people perceive their surroundings. Discussion topics focused on perceived barriers, suggestions to improve cervical cancer screening uptake, and acceptability. Results: A total of 16 HCPs were interviewed between July and August 2019. The identified barriers were (1) lack of basic knowledge on cervical cancer among most women and men and (2) lack of awareness of the role and existence of a screening programme to prevent it. Screening for cervical cancer prevention using HPV self-sampling was considered as an acceptable approach for patients according to HCPs. Traditional chiefs were identified as key entry points to raise awareness because they were perceived as essential to reach not only women, but also their male partners. Conclusions: Awareness campaigns about cervical cancer, its prevention and the availability of the screening programmes are crucial. Furthermore, involving male partners, as well as key community leaders or institutions was identified as a key strategy to encourage participation in the cervical cancer screening programme. Trial registration: Ethical Cantonal Board of Geneva, Switzerland (CCER, N°2017-0110 and CER-amendment n°2) and Cameroonian National Ethics Committee for Human Health Research (N°2018/07/1083/CE/CNERSH/SP). Community gynaecology Gynaecological oncology Preventive medicine Primary care Public health Cameroon Early Detection of Cancer Female Health Knowledge, Attitudes, Practice Health Personnel Humans Male Mass Screening Papillomavirus Infections / diagnosis Papillomavirus Infections / prevention & control Patient Acceptance of Health Care Qualitative Research Switzerland Uterine Cervical Neoplasms / diagnosis Uterine Cervical Neoplasms / prevention & control Dewey 618 Groupement Romand de la Société Suisse de Gynécologie GRSSGO-PJH-2020-1 58 Département de pédiatrie, gynécologie et obstétrique 223 false 590 Prévention du cancer du col utérin 933 BMJ open 11 6 829eb009-ac08-4b73-a806-4db1e9036683 Article (Published version) Public Article-scientifique-from-unpaywall.pdf 408872 application/pdf CC BY-NC-4.0 4dbaf7140b0b28742a2b38b4a33f0adf758129ba0ede15dc7cdc49bfea0c4d16 openAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique

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Barriers to cervical cancer prevention in rural Cameroon: a qualitative study on healthcare providers' perspective	BMJ open			2021	109	132

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Roux, Amandine Noémie