Cervical cancer screening status and implementation challenges: Report from selected states of India.
capacity mapping
cervical cancer screening
health system challenges
low resource settings
program implementation
Journal
The International journal of health planning and management
ISSN: 1099-1751
Titre abrégé: Int J Health Plann Manage
Pays: England
ID NLM: 8605825
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
revised:
28
07
2021
received:
31
10
2020
accepted:
04
10
2021
pubmed:
31
10
2021
medline:
12
3
2022
entrez:
30
10
2021
Statut:
ppublish
Résumé
Cervical cancer contributes to 6%-29% of the cancers in India. Although the Government of India in 2010 integrated cancer screening within the National Programme for the prevention of Non-communicable Diseases, only 22% of women aged 15-45 years had undergone examination of the cervix by 2016. This prompts the question regarding the organisation of the program's implementation and service delivery and regarding challenges that may explain poor screening uptake. Semi-structured interviews were held with program managers and implementers in seven districts of three selected States of India. The data analysis looked at program content, the organisation of screening delivery, and the challenges to the implementation of the program, considering six theoretically derived dimensions of public health capacity: leadership and governance, organisational structure, financial resources, workforce, partnerships, and knowledge development. Participants perceive the existing capacities across the six domains as insufficient to implement the CCS program nationwide. A context specific implementation, a better coordination between the program and district health facilities, timely remuneration, better maintenance of data and a strong monitoring system are possible solutions to remove health system related barriers. The study provides evidence on the practical challenges and provides recommendations for strengthening the capacities of the health system.
Sections du résumé
BACKGROUND
BACKGROUND
Cervical cancer contributes to 6%-29% of the cancers in India. Although the Government of India in 2010 integrated cancer screening within the National Programme for the prevention of Non-communicable Diseases, only 22% of women aged 15-45 years had undergone examination of the cervix by 2016. This prompts the question regarding the organisation of the program's implementation and service delivery and regarding challenges that may explain poor screening uptake.
METHODS
METHODS
Semi-structured interviews were held with program managers and implementers in seven districts of three selected States of India. The data analysis looked at program content, the organisation of screening delivery, and the challenges to the implementation of the program, considering six theoretically derived dimensions of public health capacity: leadership and governance, organisational structure, financial resources, workforce, partnerships, and knowledge development.
RESULTS
RESULTS
Participants perceive the existing capacities across the six domains as insufficient to implement the CCS program nationwide. A context specific implementation, a better coordination between the program and district health facilities, timely remuneration, better maintenance of data and a strong monitoring system are possible solutions to remove health system related barriers.
CONCLUSION
CONCLUSIONS
The study provides evidence on the practical challenges and provides recommendations for strengthening the capacities of the health system.
Types de publication
Journal Article
Langues
eng
Pagination
824-838Subventions
Organisme : Co-operation au Development
Informations de copyright
© 2021 John Wiley & Sons, Ltd.
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