Abstract:
ABSTRACT
Background: Worldwide, cervical cancer is the fourth most commonly occurring cancer in women with an estimated 570,000 new cases in 2018 representing 6.6 % of all female cancers. Approximately 90% of deaths from cervical cancer occurred in low and middle – income countries. In Tanzania it is estimated that 40,000 new cases of cancer reported of which 80% of those victims die every year and the number is reported to increase. In response to that the Government of Tanzania through Ministry of Health Community Development, Gender, Elderly and Children established National Cancer Control Strategy 2013-2022 with the aim of combating cancer through several key interventions including cervical cancer screening program. This study was carried out to explore the achievement, facilitating factors and barriers for the implementation of the National Cancer Control Strategy using the case of cervical cancer screening services. The study answered the following main research question: What are the achievements, facilitating factors and barriers of the implementation of the National Cancer Control strategy in Tanzania?
Objective: To evaluate the achievements, facilitating factors and barriers for the implementation of National Cancer Control Strategy at national and district levels.
Methods and materials:A cross sectional study design was conducted where qualitative and quantitative methods of data collection were used. Qualitative data were collected by using in depth interview guide while the document review was done to collect quantitative data. Purposive sampling method was used to select participants in this study. The sample size was 12 key informants from Ministry of Health Community, Development, Gender, Elderly and Children, Ocean Road Cancer Institute and District Medical Officer office of Ilala Municipality. The thematic analysis approach was used to analyze qualitative data.
Results:The implementation of the National Cancer Control Strategy at national and district levels has recorded a number of achievements including increasing the number of trained health providers, increasing number of health facilities providing cervical cancer screening and the number of women undertaking cervical cancer screening. The findings have revealed that these achievements were facilitated by numbers of factors, including availability of services, government commitment and presence of guidelines. However, there are a few barriers affecting implementation of strategy, including inadequate of funds and donor dependency, shortage of human resources, and shortage of instruments/tools for cervical cancer screening.
Conclusion: Based on the findings of this study, it can be concluded that the achievements of the implementation of the National Cancer Control Strategy at national and district levels depends much on the capitalization of the existing facilitating factors such as government commitment, availability of guidelines, affordability of services and high demand of cervical cancer screening services. However, the government through the ministry of health and other stakeholders should address the existing barriers, including inadequate funding and donor dependency and the shortage of human resources for health in order to effectively and efficiently achieve the desired goals and objective of the National Cancer Control Strategy in the country.
Recommendations: The government and other stakeholders should find reliable sources of funding for the implementation of cervical cancer screening and deploy HRH and provision of trainings.
