Abstract 36: Examining Policies and Guidelines to Improve the Cervical Cancer Prevention and Treatment Pathway for Patients and Health Providers in Tanzania: A Qualitative Study

Melinda Chelva, Sanchit Kaushal, Nicola West, Erica Erwin, Prisca Dominic Marandu, Safina Yuma, Donna Shelley, Karen Yeates
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Abstract

Abstract Purpose: Cervical cancer is the fourth most common cancer in women around the globe. It has been identified as the most common cancer in Tanzania, resulting in about 9772 new cases and 6695 deaths each year. Several research studies have identified the importance of adequate and timely policies and guidelines to optimize the cervical cancer prevention and treatment pathway in the nation. However, there is scant literature on the perspectives of all stakeholders (e.g., patients, key informants, healthcare providers, and non-healthcare providers). Our study aims to better understand the recommendations from important stakeholders to inform current and upcoming policies and guidelines, and overall, improve the cervical cancer screening and treatment cascade in rural Tanzania and other African countries. Methods: We leveraged a framework for conducting a health systems assessment to identify healthcare providers’ perspectives on effective cervical cancer screening, prevention and control in Tanzania. We adapted interview topic guides for cervical cancer screening using the health systems assessment framework conceptualized by Risso-Gill and colleagues designed initially for evaluating hypertension control. Study participants (71) were interviewed between 2014-2018. This included key stakeholders, patients, healthcare providers and non-healthcare providers. Results: Through the interviews and focus group discussions that were conducted, three major themes emerged: 1) policies and guidelines, 2) burden of disease in relation to policies, and 3) treatment and follow-up. Sub-themes relating to policies and guidelines included health policies, governmental influence, data collection, and revision of HPV vaccination guidelines. Sub-themes for burden of disease included the rise in overall cases of cervical cancer. Subthemes for treatment and follow-up included quality of care, dissatisfaction with care, and patient safety and well-being. Conclusion: It is evident that significant changes must be made to existing policies and guidelines to improve many aspects of the cervical cancer screening and treatment pathway, to benefit healthcare providers and patients alike in rural Tanzania. There is also a critical need to implement new initiatives and programs to increase uptake and allow for informed-decision making among women. Citation Format: Melinda Chelva, Sanchit Kaushal, Nicola West, Erica Erwin, Prisca Dominic Marandu, Safina Yuma, Donna Shelley, Karen Yeates. Examining Policies and Guidelines to Improve the Cervical Cancer Prevention and Treatment Pathway for Patients and Health Providers in Tanzania: A Qualitative Study [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 36.
摘要36:检查政策和指导方针,以改善坦桑尼亚患者和卫生服务提供者的宫颈癌预防和治疗途径:一项定性研究
目的:宫颈癌是全球第四大最常见的女性癌症。它已被确定为坦桑尼亚最常见的癌症,每年导致约9772例新病例和6695例死亡。一些研究已经确定了适当和及时的政策和指南对于优化国家宫颈癌预防和治疗途径的重要性。然而,关于所有利益相关者(例如,患者、关键举报人、医疗保健提供者和非医疗保健提供者)的观点的文献很少。我们的研究旨在更好地了解重要利益相关者的建议,为当前和即将出台的政策和指导方针提供信息,并总体上改善坦桑尼亚农村和其他非洲国家的宫颈癌筛查和治疗梯级。方法:我们利用框架进行卫生系统评估,以确定在坦桑尼亚有效的宫颈癌筛查,预防和控制医疗保健提供者的观点。我们采用Risso-Gill及其同事最初为评估高血压控制而设计的卫生系统评估框架,对宫颈癌筛查的访谈主题指南进行了改编。研究参与者(71人)在2014-2018年间接受了采访。这包括关键利益攸关方、患者、医疗保健提供者和非医疗保健提供者。结果:通过访谈和焦点小组讨论,出现了三个主要主题:1)政策和指南,2)与政策相关的疾病负担,3)治疗和随访。与政策和指南有关的次级主题包括卫生政策、政府影响、数据收集和修订HPV疫苗接种指南。疾病负担的分主题包括宫颈癌总病例的增加。治疗和随访的次要主题包括护理质量、对护理的不满以及患者的安全和健康。结论:显然,必须对现有政策和指导方针进行重大修改,以改善宫颈癌筛查和治疗途径的许多方面,使坦桑尼亚农村的医疗保健提供者和患者都受益。还迫切需要实施新的倡议和方案,以提高妇女的吸收能力,并允许妇女作出知情决策。引文格式:Melinda Chelva, Sanchit Kaushal, Nicola West, Erica Erwin, Prisca Dominic Marandu, Safina Yuma, Donna Shelley, Karen Yeates。审查政策和指导方针,以改善坦桑尼亚患者和保健提供者的宫颈癌预防和治疗途径:一项定性研究[摘要]。第11届全球癌症研究年会论文集;缩小从研究到实施的差距;2023年4月4-6日。费城(PA): AACR;癌症流行病学杂志[j]; 2013;32(6 -增刊):摘要第36期。
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