Browse > Article
http://dx.doi.org/10.7314/APJCP.2012.13.6.2913

Influencing Women's Actions on Cervical Cancer Screening and Treatment in Karawang District, Indonesia  

Kim, Young-Mi (Jhpiego, Johns Hopkins University)
Ati, Abigael (Jhpiego, Johns Hopkins University)
Kols, Adrienne (Jhpiego, Johns Hopkins University)
Lambe, Fransisca Maria (Jhpiego, Johns Hopkins University)
Soetikno, Djoko (Jhpiego, Johns Hopkins University)
Wysong, Megan (Jhpiego, Johns Hopkins University)
Tergas, Ana Isabel (Johns Hopkins Medical Institute (JHMI))
Rajbhandari, Presha (Jhpiego, Johns Hopkins University)
Lu, Enriquito (Jhpiego, Johns Hopkins University)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.13, no.6, 2012 , pp. 2913-2921 More about this Journal
Abstract
Introduction: The impact of cervical cancer prevention programs depends on persuading women to go for screening and, if needed, treatment. As part of an evaluation of a pilot project in Indonesia, qualitative research was conducted to explore the factors that influence women's decisions regarding screening and treatment and to generate practical recommendations to increase service coverage and reduce loss to follow up. Methods: Research was conducted at 7 of the 17 public health centers in Karawang District that implemented the pilot project. Interviews and focus group discussions were held with 20 women, 20 husbands, 10 doctors, 18 midwives, 3 district health officials, and 16 advocacy team members. Results: Free services and mobile outreach events encouraged women to go for screening, along with promotional efforts by community health workers, advocacy teams, and the mass media. Knowledge and perceptions were the most important barriers to screening: women were not aware of cervical cancer risks, did not know the disease was treatable, and were fatalistic. Factors facilitating treatment were social support from husbands, relatives, and friends and the encouragement and role modeling of health workers. Barriers to prompt treatment included limited access to services and the requirement for husband's consent for cryotherapy. Conclusion: As cervical cancer prevention services are scaled up throughout Indonesia, the findings suggest three strategies to expand screening coverage and ensure prompt treatment: strengthening community mobilization and advocacy activities, modifying the service delivery model to encourage a single visit approach to screening and treatment, and working to gain men's support.
Keywords
Cancer screening; cervical cancer; cancer prevention; Indonesia;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Agurto I, Bishop A, Sanchez G, et al (2004). Perceived barriers and benefits to cervical cancer screening in Latin America. Prev Med, 39, 91-8.   DOI
2 Agurto I, Arrossi S, White S, et al (2005). Involving the community in cervical cancer prevention programs. Int J Gynaecol Obstet, 89, S38-45.   DOI
3 Ahmed T, Ashrafunnessa, Rahman J (2008). Development of a visual inspection programme for cervical cancer prevention in Bangladesh. Reprod Health Matters, 16, 78-85.   DOI   ScienceOn
4 Almonte M, Ferreccio C, Winkler JL, et al (2007). Cervical screening by visual inspection, HPV testing, liquid-based and conventional cytology in Amazonian Peru. Int J Cancer, 121,796-802.   DOI   ScienceOn
5 Ansink AC (2007). Cervical cancer in developing countries: how can we reduce the burden? Awareness raising, screening, treatment and palliation. Trop Doct, 37, 67-70.   DOI
6 Belinson JL, Pretorius RG, Zhang WH, et al (2001). Cervical cancer screening by simple visual inspection after acetic acid. Obstet Gynecol, 98, 441-4.   DOI
7 Bradley J, Coffey P, Arrossi S, et al (2006). Women's perspectives on cervical screening and treatment in developing countries: experiences with new technologies and service delivery strategies. Women Health, 43, 103- 21.   DOI
8 Bingham A, Bishop A, Coffey P, et al (2003). Factors affecting utilization of cervical cancer prevention services in lowresource settings. Salud Publica Mex, 45, S408-16.
9 Blumenthal PD, Gaffikin L, Deganus S, et al (2007). Cervical cancer prevention: safety, acceptability, and feasibility of a single-visit approach in Accra, Ghana. Am J Obstet Gynecol, 196, 407.e1-407.e9.   DOI
10 Blumenthal PD, Lauterbach M, Sellors JW, Sankaranarayanan R (2005). Training for cervical cancer prevention programs in low-resource settings: focus on visual inspection with acetic acid and cryotherapy. Int J Gynaecol Obstet, 89 Suppl 2: S30-7.   DOI
11 Gaffikin L, Blumenthal PD, Emerson M, et al (2003). Safety, acceptability, and feasibility of a single-visit approach to cervical-cancer prevention in rural Thailand: a demonstration project. Lancet, 361, 814-20.   DOI   ScienceOn
12 Cervical Cancer Action (CCA) (2012). Progress in Cervical Cancer Prevention: The CCA Report Card. Available from: http://www.cervicalcanceraction.org/pubs/pubs. php; accessed April 30, 2012.
13 Chamot E, Kristensen S, Stringer JS, et al (2010). Are treatments for cervical precancerous lesions in lessdeveloped countries safe enough to promote scaling-up of cervical screening programs? A systematic review. BMC Womens Health, 10, 11.   DOI
14 Denny L, Kuhn L, De Souza M, et al (2005). Screen-and-treat approaches for cervical cancer prevention in low-resource settings: a randomized controlled trial. JAMA, 294, 2173- 81.   DOI
15 Forouzanfar MH, Foreman KJ, Delossantos AM, et al (2011). Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis. Lancet, 378, 1461-84.   DOI
16 Ferlay J, Shin HR, Bray F, et al (2010). GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer. Available from: http:// globocan.iarc.fr; accessed November 21, 2011.
17 Goldhaber-Fiebert JD, Denny LE, De Souza M, et al (2005). The costs of reducing loss to follow-up in South African cervical cancer screening. Cost Eff Resour Alloc, 3, 11.   DOI
18 Goldie SJ, Gaffikin L, Goldhaber-Fiebert JD, et al (2005). Cost-effectiveness of cervical-cancer screening in five developing countries. N Engl J Med, 353, 2158-68.   DOI
19 Luciani S, Winkler J (2006). Cervical Cancer prevention in Peru: Lessons learned from the TATI demonstration project. Pan American Health Organization, Washington, DC.
20 Kim YM, Lambe FM, Ati A, et al (2011). The Evaluation of the Cervical Cancer Prevention (CECAP) Project in Karawang District, Indonesia. Jhpiego, Baltimore.
21 Luciani S, Gonzales M, Munoz S, et al (2008). Effectiveness of cryotherapy treatment for cervical intraepithelial neoplasia. Int J Gynaecol Obstet, 101, 172-7.   DOI
22 Mupepi SC, Sampselle CM, Johnson TR (2011). Knowledge, attitudes, and demographic factors influencing cervical cancer screening behavior of Zimbabwean women. J Womens Health (Larchmt), 20, 943-52.   DOI
23 Mathers LJ, Wigton TR, Leonhardt JG (2005) Screening for cervical neoplasia in an unselected rural Guatemalan population using direct visual inspection after acetic acid application: a pilot study. J Low Genit Tract Dis, 9, 232-5.   DOI
24 Mandelblatt JS, Lawrence WF, Gaffikin L, et al (2002). Costs and benefits of different strategies to screen for cervical cancer in developing countries. J Natl Cancer Inst, 94, 1469-83.   DOI
25 Megevand E, Denny L, Dehaeck K, et al (1996). Acetic acid visualization of the cervix: an alternative to cytologic screening. Obstet Gynecol, 88, 383-6.   DOI
26 Necochea E, Bossemeyer D (2005). Standards-Based Management and Recognition (SBM-R-A Field Guide: A Practical Approach for Improving the Performance and Quality of Health Services. Jhpiego, Baltimore.
27 Mwanahamuntu MH, Sahasrabuddhe VV, Pfaendler KS, et al (2009). Implementation of 'see-and-treat' cervical cancer prevention services linked to HIV care in Zambia. AIDS, 23, 1-5.   DOI
28 Nene B, Jayant K, Arrossi S, et al (2007). Determinants of womens participation in cervical cancer screening trial, Maharashtra, India. Bull World Health Organ, 85, 264-72.   DOI
29 Nene BM, Hiremath PS, Kane S, et al (2008). Effectiveness, safety, and acceptability of cryotherapy by midwives for cervical intraepithelial neoplasia in Maharashtra, India. Int J Gynaecol Obstet, 103, 232-6.   DOI
30 Obi SN, Ozumba BC, Nwokocha AR, et al(2007). Participation in highly subsidized cervical cancer screening by women in Enugu, Southeast Nigeria. J Obstet Gynaecol, 27, 305- 7.   DOI
31 Othman NH, Rebolj M (2009). Challenges to cervical screening in a developing country: The case of Malaysia. Asian Pac J Cancer Prev, 10, 747-52.
32 Sankaranarayanan R, Rajkumar R, Theresa R, et al(2004). Initial results from a randomized trial of cervical visual screening in rural south India. Int J Cancer, 109, 461-7.   DOI
33 Perkins RB, Langrish S, Stern LJ, et al(2007). A communitybased education program about cervical cancer improves knowledge and screening behavior in Honduran women. Rev Panam Salud Publica, 22, 187-93.
34 Phongsavan K, Phengsavanh A, Wahlstrom R, et al(2011). Safety, feasibility, and acceptability of visual inspection with acetic acid and immediate treatment with cryotherapy in rural Laos. Int J Gynaecol Obstet, 114, 268-72.   DOI
35 Sanghvi H, Limpaphayom KK, Plotkin M, et al (2008). Cervical cancer screening using visualinspection with acetic acid: operational experiences from Ghana and Thailand. Reprod Health Matters, 16, 67-77.   DOI
36 Wellensiek N, Moodley M, Moodley J, et al(2002). Knowledge of cervical cancer screening and use of cervical screening facilities among women from various socioeconomic backgrounds in Durban, Kwazulu Natal, South Africa. Int J Gynecol Cancer, 12, 376-82.   DOI
37 Sankaranarayanan R, Nene BM, Dinshaw KA, et al(2005). A cluster randomized controlled trial of visual, cytology and human papillomavirus screening for cancer of the cervix in rural India. Int J Cancer, 116, 617-623.   DOI
38 Sankaranarayanan R, Esmy PO, Rajkumar R, et al(2007). Effect of visual screening on cervical cancer incidence and mortality in in Tamil Nadu, India: a cluster-randomised trial. Lancet, 370, 398-406.   DOI
39 Sankaranarayanan R, Rajkumar R, Esmy PO, et al (2007). Effectiveness, safety and acceptability of 'see and treat' with cryotherapy by nurses in a cervical screening study in India. Br J Cancer, 96, 738-43.   DOI
40 University of Zimbabwe, JHPIEGO Cervical Cancer Project (1999). Visual inspection with acetic acid for cervical cancer screening: Test qualities in a primary care setting. Lancet, 353, 869-73.   DOI
41 Winkler JL, Wittet S, Bartolini RM, et al. (2008). Determinants of human papillomavirus vaccine acceptability in Latin America and the Caribbean. Vaccine, 26, L73-9.   DOI