Perspectives of women and healthcare providers on facilitators and barriers to cervical cancer screening in the rural Kilimanjaro region Tanzania: a qualitative study.

BACKGROUND

Cervical cancer can be prevented and treated if detected early through regular screening. However, 88% of women aged 30 to 49 have never been screened in Tanzania.

OBJECTIVE

This study explored facilitators and barriers to cervical cancer screening among women and healthcare providers in rural Kilimanjaro, Tanzania, using the Theoretical Domains Framework and the Capability, Opportunity, Motivation-Behavior model.

METHODS

An exploratory qualitative design was employed; data were collected from March to October 2024. Six focus group discussions were conducted with 54 women aged 30-50 years, and twelve in-depth individual interviews with healthcare providers. Data were transcribed, coded, and thematically analyzed using QDA Miner Lite v2.0.8.

RESULTS

Four main themes emerged, each with sub-themes: (1) knowledge about cervical cancer and screening (disparities in knowledge between screened and non-screened women; healthcare providers' knowledge and training needs; age and parity as knowledge mediators); (2) power of social influence (social facilitation; social barriers); (3) emotional and structural influences on cervical cancer screening (emotional barriers and coping; structural and logistical barriers); and (4) enhancing cervical cancer screening uptake (targeted community education and outreach; improving service accessibility). Barriers include limited knowledge, misconceptions, fear of pain and positive results, limited access to services, and a shortage of trained healthcare providers. Social support from families, peers, community leaders, and healthcare providers was identified as a strong facilitator.

CONCLUSION

Increasing cervical cancer screening uptake in rural communities requires targeted, theory-informed interventions that incorporate education to enhance awareness, strengthen social support, and improve health services.