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Barriers and facilitators to effective cervical cancer screening in Belize: a qualitative analysis.
Mittal, Avni; Neibart, Shane S; Kulkarni, Abha; Anderson, Taylor; Hudson, Shawna V; Beer, Natalia Largaespada; Einstein, Mark H; Kohler, Racquel E.
Afiliação
  • Mittal A; Department of Obstetrics and Reproductive Health and Gynecology, Rutgers New Jersey Medical School, Newark, NJ, USA.
  • Neibart SS; Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA. sneibart@partners.org.
  • Kulkarni A; Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
  • Anderson T; University of Queensland Ochsner Clinical School, Brisbane, QLD, Australia.
  • Hudson SV; Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
  • Beer NL; Department of Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
  • Einstein MH; Ministry of Health, Belmopan, Belize.
  • Kohler RE; Department of Obstetrics and Reproductive Health and Gynecology, Rutgers New Jersey Medical School, Newark, NJ, USA.
Cancer Causes Control ; 34(8): 647-656, 2023 Aug.
Article em En | MEDLINE | ID: mdl-37165111
ABSTRACT

PURPOSE:

Belize has among the highest cervical cancer incidence and mortality rates of Latin American and Caribbean countries. This study evaluates the perspectives of key stakeholders for cervical cancer screening in Belize and identifies the barriers and facilitators for providing equitable access to prevention services.

METHODS:

Semi-structured interviews discussing cervical cancer screening were conducted with key stakeholders across the six districts of Belize in 2018. Interviews were transcribed, coded, and analyzed thematically; themes were organized by levels of the social-ecological model.

RESULTS:

We conducted 47 interviews with health care providers (45%), administrators (17%), government officials (25%), and other stakeholders (13%). Majority (78%) of interviews were from the public sector. Perceived barriers to cervical cancer screening were identified across multiple levels (1) Individual Patient potential delays in Pap smear results and fear of a cancer diagnosis; (2) Provider competing clinician responsibilities; (3) Organizational insufficient space and training; (4) Community reduced accessibility in rural areas; and (5) Policy equipment and staffing budget limitations. The main facilitators we identified included the following (1) at the Community level resource-sharing between public and private sectors and dedicated rural outreach personnel; (2) at the Policy level free public screening services and the establishment of population-based screening.

CONCLUSION:

Despite free, publicly available cervical cancer screening in Belize, complex barriers affect access and completion of management when abnormal screening tests are identified. Provider workload, education outreach, and additional funding for training and facilities are potential areas for strengthening this program and increasing detection and management for cervical cancer control.
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Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 10_ODS3_salud_sexual_reprodutiva / 1_ASSA2030 / 2_ODS3 / 6_ODS3_enfermedades_notrasmisibles Base de dados: MEDLINE Assunto principal: Neoplasias do Colo do Útero Tipo de estudo: Diagnostic_studies / Prognostic_studies / Qualitative_research / Screening_studies Limite: Female / Humans País/Região como assunto: America central / Belice / Caribe ingles Idioma: En Revista: Cancer Causes Control Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 10_ODS3_salud_sexual_reprodutiva / 1_ASSA2030 / 2_ODS3 / 6_ODS3_enfermedades_notrasmisibles Base de dados: MEDLINE Assunto principal: Neoplasias do Colo do Útero Tipo de estudo: Diagnostic_studies / Prognostic_studies / Qualitative_research / Screening_studies Limite: Female / Humans País/Região como assunto: America central / Belice / Caribe ingles Idioma: En Revista: Cancer Causes Control Ano de publicação: 2023 Tipo de documento: Article