An exploration of opportunities and challenges facing cervical cancer managers in Kenya

BMC Research Notes

Geoff McDonnell³  Roudsari Abdul²  Ganesh P Pokhariyal⁴  Lucy W Kivuti-Bitok¹ 

[1] School of Nursing Sciences, University of Nairobi, P.O BOX 19676-KNH-00202, Nairobi, Kenya;Health and Information Science, University of Victoria, PO Box 3050 STN CSC, Victoria, BC, V8W 3P5, Canada;Centre for Health Informatics, University of New South Wales, Sydney, NSW, 2052, Australia;School of Mathematics, University of Nairobi, P.O Box 30196-GPO-00100, Nairobi, Kenya

关键词: Kenya;    Health care managers;    Cervical cancer;    Opportunities;    Attitudes;    Challenges;   

Others  :  1142968
DOI  :  10.1186/1756-0500-6-136

 received in 2012-10-11, accepted in 2013-03-20,  发布年份 2013

【 摘 要 】

Background

Kenya like other developing countries is low in resource setting and is facing a number of challenges in the management of cervical cancer. This study documents opportunities and challenges encountered in managing cervical cancer from the health care workers’ perspectives. A qualitative study was conducted among cervical cancer managers who were defined as nurses and doctors involved in operational level management of cervical cancer. The respondents were drawn from four provincial hospitals and the only two main National public referral hospitals in Kenya. Twenty one [21] nurse managers and twelve [12] medical doctors were interviewed using a standardized interview guide. The responses were audio recorded, transcribed verbatim and the content analyzed in emerging themes.

Findings

Four themes were identified. Patient related challenges included a large number of patients, presenting in the late stage of disease, low levels of knowledge on cancer of the cervix, low levels of screening and a poor attitude towards screening procedure. Individual health care providers identified a lack of specialised training, difficulty in disclosure of diagnosis to patients, a poor attitude towards cervical cancer screening procedure and a poor attitude towards cervical cancer patients. Health facilities were lacking in infrastructure and medical supplies. Some managers felt ill-equipped in technological skills while the majority lacked access to the internet. Mobile phones were identified as having great potential for improving the management of cervical cancer in Kenya.

Conclusion

Kenya faces a myriad of challenges in the management of cervical cancer. The peculiar negative attitude towards screening procedure and the negative attitude of some managers towards cervical cancer patients need urgent attention. The potential use of mobile phones in cervical cancer management should be explored.

【 授权许可】

   
2013 Kivuti-Bitok et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]WHO/ICO Information Centre on HPV and Cervical Cancer (HPV Information Centre): Human Papillomavirus and Related Cancers in Kenya. Summary Report 2010. : ; [25th March 2013]. Available at http://www.who.int/hpvcentre webcite
• [2]Makin MS, Fort VK, Siegler AJ, Ault K, Rochat R: Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study. Patient Preference and Adherence 2011, 5:125-131.
• [3]Bingham A, Bishop A, Coffey P, Winkler J, Bradley J, Dzuba I, Agurto I: Factors affecting utilization of cervical cancer prevention services in low-resource settings. Salud Publica Mex 2003, 45(suppl 3):S408-S416.
• [4]Weiderpass E, Mutyaba T, Faxelid E, Mirembe F: Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening. Reprod Heal 2007., 4
• [5]Denny L, Quinn M, Sankaranarayanan R: Screening for cervical cancer in developing countries. Vaccine 2006, 24(S3):S3/71–S3/77.
• [6]Chirenje ZM, Rusakaniko S, Kirumbi L, Ngwalle EW: Situation analysis for cervical cancer diagnosis and treatment in East. Central and Southern African countries. Bulletin of the World Health Organization 2001, 2:79.
• [7]Bailie RS, Selvey CE, Bourne D, Bradshaw D: Trends in cervical cancer mortality in South Africa. Int J Epidemio 1996, 3:25. 488-93
• [8]Kawonga M, Fonn S: Achievieng effective cervical cancer screening coverage in South Africa through human resources and health systems development. Reprod Health Matters 2008, 32(16):32-40.
• [9]Guest G, Bunce A, Johnson L: How Many Interviews Are Enough? An Experiment with Data Saturation and Variability. Field Methods February 2006, 18(1):59-82.
• [10]Arrossi A, Paolino M, Sankaranarayanan R: Challenges faced by cervical cancer prevention programs in developing countries: a situational analysis of program organization in Argentina. Rev Panam Salud Publica 2010, 4(28):249-57.
• [11]Mutyaba T, Faxelid E, Mirembe F, Weiderpass E: Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening. Reprod Heal 2007. June 26
• [12]Goldsmith MR, Bankhead RC, Kehoe ST, Marsh G, Austoker JG: Information and cervical screening: a qualitative study of women’s awareness, understanding and information needs about HPV. J Med Screen 2007, 14:29-33. Available at http://jms.rsmjournals.com/content/14/1/29.full.pdf webcite
• [13]Claeys P: Cervical Cancer Screening In Resource-Poor Settings Evidence From Nicaragua and Kenya.PhD Thesis. Ghent University: Faculty of Medicine and Health Sciences; 2003.
• [14]Huchko JM, Bukusi EA, Cohen CR: Building capacity for cervical cancer screening in outpatient HIV clinics in the Nyanza province of western Kenya. Int J Gynecol Obstet 2011.
• [15]Audet CM, Matos CS, Blevins M, Cardoso A, Moon TD, Sidat M: Acceptability of cervical cancer screening in rural Mozambique. Health Educ Res 2012, 27(3):544-551. Available from. http://her.oxfordjournals.org webcite
• [16]Becker-Dreps S, Otieno WA, Brewer NT, Agot K, Smith JS: HPV vaccine acceptability among Kenyan women. Vaccine 2010, 28:4864-4867.
• [17]DiAngi YT, Panozzo CA, Ramogola-Masire D, Steenhoff AP, Brewer NT: A Cross-Sectional Study of HPV Vaccine Acceptability in Gaborone, Botswana. PLoS One 2011, 6(10):e25481.
• [18]Bukachi F, Pakenham-Walsh N: Information Technology for Health in Developing Countries. Chest 2007., 1321624-1630 DOI. 132
• [19]Gormley R, Ting S, Szep Z, Steiner A, Ramogola-Masire D, Kovarik CL: Use of mobile telemedicine for cervical cancer screening of HIV-positive women in Gaborone. Botswana Infectious Agents and Cancer 2010, 5(Suppl 1):A86. BioMed Central Full Text