Challenges of Providing Cervical Cancer Prevention Programs In Iran: A Qualitative Study

摘要

Background: Cervical cancer has become a major public health problem worldwide. Iran, like other developingcountries, is facing a number of challenges in managing the disease. This qualitative study documents challengesencountered in cervical cancer preventing programs in Iran. Materials and Methods: In-depth interviews wereconducted with 28 participants including eleven patients with cervical cancer, three gynecologic oncologists, fivespecialists in Obstetrics and Gynecology, five midwives, three health care managers and one epidemiologist inMashhad Iran, between May and December of 2012. The sample was selected purposively until data saturationwas achieved. Data credibility verified via allocated sufficient time for data collection, using member checkingand peer debriefing. Data analysis was carried out using conventional content analysis approach with ATLAS. tisoftware. Results: Findings from data analysis demonstrated 2 major themes and 6 categories about challenges ofproviding cervical cancer prevention programs including: individual and social challenges (cognitive/behavioralchallenges and socio/cultural challenges) and health system challenges (stewardship, financing, competency ofhealth care providers and access to services). Each category included some subcategories. Conclusions: Managingthe cervical cancer prevention programs need to include the consideration of individuals, health care providersand health system challenges. Addressing the low level of knowledge, negative attitudes, socio cultural challenges,Poor intersectional collaboration and coordination and intra-sectional management, financing and competencyof health care providers are essential steps toward significantly reducing the burdens of cervical cancer.