Barriers and Facilitators to Cervical cancer screening in Nepal: a qualitative study

Abstract

Background: Despite of being the most preventable cancer, cervical cancer remains to be the most common cancer among women in Nepal. Nationwide population based screening programme is still lacking in Nepal though government addresses cervical cancer screening strategies in its health policy. Women even from urban area having access to health care facilities have very low screening rates. It is important to investigate and understand the factors affecting cervical cancer screening. Objective: To explore perceived barriers and facilitators to cervical cancer screening among women in Nepal. Methods: A qualitative study was conducted in Dhulikhel hospital and Dhulikhel municipality among 72 married women of 25-60 years of age who were purposefully sampled and were invited to discuss in seven focus groups. The interviews were tape recorded, transcribed in verbatim and analyzed using manifest content analysis. Results: The women had low knowledge on cervical cancer and low awareness on screening. Personal barriers, limited finances, socio-cultural barriers, long distances to a screening facility, service provider’s behaviour and other complex barriers were perceived as obstacles to cervical cancer screening by the women. However, women also perceived that facilitating factors like awareness programme, financial support, screening access and motivations can persuade them to go for cervical cancer screening. Conclusions: Misconceptions regarding the cervical cancer disease and its causes, the concept and aim of screening, and various barriers are interconnected factors that influence women’s likelihood to participate in cervical cancer screening together with modifying variables, their self-efficacy and cues of action they dispose