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Systems Appraisal of Cervical Cancer Prevention Services in Tanzania  \nMelinda Chelva 1,*, Sanchit Kaushal 2, Nicola West 1, Erica Erwin 1, Safina Yuma 3, Jessica Sleeth 4, Khadija I. Yahya-Malima 5, Donna Shelley 6, Isabelle Risso-Gill 7 and Karen Yeates 1  \nCitation: Chelva, M.; Kaushal, S.; West, N.; Erwin, E.; Yuma, S.; Sleeth, J.; Yahya-Malima, K.I.; Shelley, D.; Risso-Gill, I.; Yeates, K.“In the Village That She Comes from, Most of the People Don’t Know Anything about Cervical Cancer”: A Health Systems Appraisal of Cervical Cancer Prevention Services in Tanzania. Int. J. Environ. Res. Public Health 2024, 21, 1059. [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)ijerph21081059  \nAcademic Editor: Melinda S. Butsch Kovacic  \nReceived: 1 May 2024  \nRevised: 25 July 2024  \nAccepted: 11 August 2024  \nPublished: 13 August 2024  \nCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada  \n2 Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada  \n3 Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma P.O. Box 743, Tanzania  \n4 Canadian Cancer Trials Group, Kingston, ON K7L 2V5, Canada  \n5 Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania  \n6 School of Global Public Health, New York University, New York, NY 10003, USA  \n7 Specialty Registrar in Public Health, National Health Service (NHS), London SE1 8UG, UK  \n* Correspondence: [16mc3@queensu.ca](16mc3@queensu.ca)  \nAbstract: Introduction: Cervical cancer is the fourth most common cancer in women globally. It is the most common cancer in Tanzania, resulting in about 9772 new cases and 6695 deaths each year. Research has shown an association between low levels of risk perception and knowledge of the prevention, risks, signs, etiology, and treatment of cervical cancer and low screening uptake, as contributing to high rates of cervical cancer-related mortality. However, there is scant literature on the perspectives of a wider group of stakeholders (e.g., policymakers, healthcare providers (HCPs), and women at risk), especially those living in rural and semi-rural settings. The main objective of this study is to understand knowledge and perspectives on cervical cancer risk and screening among these populations. Methods: We adapted Risso-Gill and colleagues’ framework fora Health Systems Appraisal (HSA), to identify HCPs’ perspective of the extent to which health system requirements for effective cervical cancer screening, prevention, and control are in place in Tanzania. We adapted interview topic guides for cervical cancer screening using the HSA framework approach. Study participants (69 in total) were interviewed between 2014 and 2018—participants included key stakeholders, HCPs, and women at risk for cervical cancer. The data were analyzed using reflexive thematic analysis methodology. Results: Seven themes emerged from our analysis of semi-structured interviews and focus groups: (1) knowledge of the role of screening and preventive care/services (e.g., prevention, risks, signs, etiology, and treatment),(2) training and knowledge of HCPs,(3) knowledge of cervical cancer screening among women at risk,(4) beliefs about cervical cancer screening,(5) role of traditional medicine,(6) risk factors, and (7) symptoms and signs. Conclusions: Our results demonstrate that there is a low level of knowledge of the role of screening and preventive se","cbCaitM1NPZqfk1m","https://ap.wps.com/l/cbCaitM1NPZqfk1m","pdf",1346827,"English","# Abstract\n# Introduction\n## Global burden and disparities\n## WHO strategy and screening approaches\n# Methods\n## Health Systems Appraisal framework\n## Participants and data analysis\n# Results\n## Seven emergent themes\n# Conclusions","[{\"question\":\"What was the main objective of the study?\",\"answer\":\"To understand knowledge and perspectives on cervical cancer risk and screening among stakeholders and women living in rural and semi-rural areas in Tanzania.\"},{\"question\":\"How did the study evaluate health systems for cervical cancer prevention and screening?\",\"answer\":\"It adapted a Health Systems Appraisal framework to identify the extent to which health system requirements for effective screening, prevention, and control were in place, using adapted interview topic guides and reflexive thematic analysis.\"},{\"question\":\"What did the results show about knowledge and screening-related services?\",\"answer\":\"There was a low level of knowledge about the role of screening and preventive services among stakeholders, health care providers, and women in rural and semi-rural locations, indicating a critical need for more initiatives to increase screening uptake.\"}]","“In the Village That She Comes from, Most of the People Don’t Know Anything about Cervical Cancer” - A Health Systems Appraisal of Cervical Cancer Prevention Services in Tanzania | PDF",1790033346,48]