Provider characteristics and facility barriers to implementation of single visit approach to cervical cancer in Kinondoni

Abstract

Background:The MOHCDGEC cervical cancer prevention and treatment policy reccomends VIA combined with immediate treatment of precancerous lesions with cryotherapy in a single visit.The approach is recommended as it reduces chances of clients who are lost to follow-up.The recommendations is screening procedures after every three years following a normal result except HIV positive women who should be screened annually.Following abdomal results and or treatment,the screening should be repeated in one year and if follow-up screening is normal should be screened again after three years.HIV positive women should be screened annually regardless of the results of the treatment. Objectives: The primary objective of this study was to provide indepth analysis into provider characteristics and facility barriers responsible for poor implementation of single visit approach in Kinondoni Municipal. Methods:This was exploratory crossectional study design of healthcare providers who were trained to provide cervical cancer screening and treatment services.The study was conducted in one public hospital, one public dispensary and two private dispensaries in Kinondoni Municipal.The selection of facilities and key informants was done purposively considering the availability of VIA and cryotherapy services and trained providers with experience to provide services for at least three months and who were able to narrate their own experiences in service provision.There were nine healthcare providers from all four facilities and all were included in the interview. The study excluded those providers who were still being mentored to build their skills for this service.A total of nine healthcare providers were interviewed from all four facilities.Data collection was done using key informant interview with topic guide.Tape recorders and note books were used to capture the responses and recorded the observations. Data analysis was done through conventional content analysis to group categories into themes.

Results: All informants were aware of SVA policy.Barriers to service provision included: Limited number of trained staff, inadequate supportive supervision, poor supply of equipment and supplies, failure to afford cost of VIA and treatment and poor referral sytem. Conclusion: Thestudy identifies and analyses several factors responsible for the poor implementation of single visit approach to cervical cancer screening and treatment services.It calls for multisectoral collaboration for planning and allocation of resources and instituting effective mechanisms to monitor policies across all levels.