Perceptions of the cervical cancer screening programme in Sri Lanka, among healthcare workers in Kalutara district

Abstract

Background: Even after 20 years of existence of the cervical cancer programme with pap smears, there is no marked reduction in the incidence of cervical cancer in Sri Lanka. Therefore, the cervical cancer screening programme needs to be reviewed again. Objective: To explore the perceptions of cervical cancer screening programme among health care workers. Methods: Focus group Discussion (FGD) sessions among Public Health Midwives (n=4) and Key Informant Interviews (KII) (n=10) among health care workers in the Kalutara district were conducted. A convenient sampling technique was used. Public Health Midwives for each focus group (n=8) were selected according to their seniority and the representation of communities. Triangulation methodology was used. At last summary, results were prepared and analysis was done by manual content. Results: Majority of the participants were Sinhalese (n=41, 97.6%), Buddhist (n=39, n=92.9%) and over 40 years of age (n=31, n=73.8%). Some had >20 years of service in the field (n=14, n=33.3%). Some participants mentioned the low sensitivity of pap smears and therefore the missing of lesions, unsatisfactory smears, and reporting delay due to the work burden of cytoscreeners as disadvantages of the pap smear method. Increase community awareness, supervision of WWC activities, conduction of mobile clinics indicated as pathways to improve the coverage by the participant. HPV/DNA test was well accepted as its sensitivity is high, while the majority stated to improve the coverage by vaginal specimens as the procedure is simple and can be done even by public health midwives. Conclusions: Increase community awareness, supervision, and mobile clinics to cover hard to reach population were mainly stated to improve the coverage. The Vaginal HPV/DNA specimens were mentioned as a new tool to improve the coverage.