Challenges in cervical cancer care | Respondents by hospital and gender | N | |||
---|---|---|---|---|---|
 | Public hospital | Mission hospital |  | ||
 | Male | Female | Male | Female |  |
A. Individual and community related challenges | Â | Â | Â | Â | Â |
Lack of awareness amongst women; Inadequate sensitization and mobilization of communities | R5 | R1, R3, R4 | R11 | R7, R8, R9 | 8 |
Late stage disease at presentations and its management challenges | R5, R6 | R2, R3, R4, R14 | R11 | R7, R8, R10, R15 | 11 |
Inadequate psychosocial support to and abandonment of patients by relatives | R6 | Â | Â | R7, R10, R15 | 4 |
Fear of exposure (undressing and lying in lithortomy position) and perceived pain from speculum during screening | Â | R3 | R13 | R15 | 3 |
Complaints against/Stigma from other patients because of smell from cervical cancer patients | Â | R3 | Â | Â | 1 |
Patients cannot pay for services such as histology and EUA | R6 | Â | R11 | R10, R15 | 4 |
Refusal to consent | Â | Â | Â | R7, R9, R15 | 3 |
Inadequate contact address of patients and hence poor follow up to let results known to them | R5 | Â | R11 | Â | 3 |
B. Individual health professional related challenges | Â | Â | Â | Â | Â |
Inadequate knowledge and skills in cervical screening, cervical cancer diagnosis and care | R5, R6 | R1, R2, R3, R14 | R10, R11, R12, R13 | R7, R8, R15 | 13 |
C. Health system related challenges | Â | Â | Â | Â | Â |
No pathologist and no Pap smear test | R5, R6 | R1 | Â | R15 | 4 |
No gynecologists or doctors in gynecology department to supervise screening, do biopsy, do operations | R5, R6 | R1, R2, R4 | Â | Â | 5 |
Delayed histology results and or specimens/results getting lost | R6 | R2, R3 | Â | R10, R15, | 5 |
Inadequate space/ward for cervical cancer patients | Â | R3 | R12 | Â | 2 |
Abandonment of histology results | R5 | Â | R11 | Â | 2 |
Long distance to and lack of transport to screening points | Â | R4, R14 | Â | R10 | 3 |
Congestion at screening, long waiting time to screening, scheduling delay | Â | Â | R11 | R7 | 2 |
Lack of formalin for biopsies | Â | R2 | Â | Â | 1 |
Few nurses and midwives to support screening and health talk to women | Â | R3, R14 | Â | R15 | 3 |
Lack of blood for transfusion before and during operations | Â | Â | R12 | R15 | 2 |
Stock out of morphine and inadequate pain control | Â | Â | Â | R7, R10 | 2 |
Hospital does not provide food to the patients who stay for long and run out of money and support | R6 | R3, R4, R14 | Â | R10 | 5 |
Inadequate labeling of clinics and lack of integration of services | R5 | Â | Â | Â | 1 |
Poor reputation of hospital and inhibiting health seeking there | R5 | Â | Â | Â | 1 |
Men health workers doing screening | Â | Â | Â | R7, R15 | 2 |
D. Health policy related challenges | Â | Â | Â | Â | Â |
Lack of vaccination against HPV | R5 | R1, R2 | R11,R12, R13 | R15 | 7 |
Radiotherapy is very far and patient cannot afford transport and cost of care in city | R6 | R14 | Â | Â | 2 |