Assessment of barriers to the cervical cancer continuum and existing interventions in 5 African countries

Several studies have been conducted in Africa on barriers to cervical cancer screening from the individual and the healthcare professional perspective, while the existing interventions to overcome these barriers have been seldom reported. Our aim was to assess the barriers to the cervical cancer continuum process from the healthcare system perspective, and interventions in place to improve screening in 5 African countries: Cȏte d’Ivoire, Ethiopia, Uganda, Zambia and Zimbabwe. As part of a training, collaborators from the five countries filled in a questionnaire on barriers to the cervical cancer continuum and interventions in place to improve screening. They had to prioritize barriers at each step of the process of the cancer continuum organization. Results were presented using outputs from INTERVENER, a web-based tool matching barriers to the cancer continuum and evidence-based interventions to overcome them. Barriers were mainly related to service availability (e.g., shortage of trained personnel for further management), and effectiveness, including information system barriers, mostly linked to an inadequate population registry. On the other hand, many interventions implemented in the countries focused on improving access to screening services. Future research should aim to understand the underlying causes of the barriers to guide the design and implementation of interventions to overcome them. As part of quality improvement, countries should monitor and evaluate the interventions’ impact over time.