Health system constraints in cervical cancer prevention in rural Namibia: A qualitative study.

Abstract

Background:  Cervical cancer remains a pressing public health concern in Namibia, with significant barriers to prevention, particularly in rural areas.

Aim:  This study explored health system's challenges and their impact on cervical cancer prevention efforts.

Setting:  This study was conducted in the Ohangwena and Kavango West regions of Namibia.

Methods:  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.

Results:  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.

Conclusion:  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.