Health system constraints affecting treatment and care among women with cervical cancer in Harare, Zimbabwe
Rattachement africain : Afrique du Sud, Zimbabwe, no. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Cervical cancer is a major cause of morbidity and mortality among women yet access to treatment and care remains a huge challenge in Zimbabwe. The objective of this study was to investigate health system constraints affecting engagement into treatment and care by women with cervical cancer in Harare, Zimbabwe. METHODS: A sequential explanatory mixed methods design was used for this study. Phase 1 comprised of two surveys namely: patient and health worker surveys with sample sizes of 134 and 78 participants respectively. Validated structured questionnaires programmed in Android tablet with SurveytoGo software were used for data collection during the surveys. Univariate analyses were conducted using STATA® version 14 to generate descriptive statistics. In phase 2, 16 in-depth interviews, 20 key informant interviews and 6 focus groups were conducted to explain survey results. Participants were purposively selected and sample sizes were informed by saturation principle. Participants in phase 1 and 2 were different. English transcripts were manually coded line by line in Dedoose software using the thematic codes that had been established from the survey data. The final codes were used to support and explain the survey data at the interpretation stages. RESULTS: Health system constraints identified in surveys were: limited or lack of training for health workers, weakness of surveillance system for cervical cancer, limited access to treatment and care, inadequate health workers, reliance of patients on out-of-pocket funding for treatment services, lack of back-up for major equipment. Qualitative inquiry revealed the following barriers to treatment and care: high costs of treatment and care, lack of knowledge about cervical cancer and bad attitudes of health workers, few screening and treating centres located mostly in urban areas, lack of clear referral system resulting in bureaucratic processes, and limited screening and treating capacities in health facilities due to lack of resources. CONCLUSION: The results of this study show that health system and its organization present barriers to access of cervical cancer treatment and care among women. Strong political will, mobilization of resources both domestically and from partners in addition to sound policies are imperative to address key health system challenges.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Health system constraints affecting treatment and care among women with cervical cancer in Harare, Zimbabwe
- Date Crossref
- 12/11/2019
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Pretoria Department of Obstetrics and Gynaecology University of Pretoria, Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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Parirenyatwa Hospital Zimbabwe (code pays fourni par la source)Établissement de santé
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Oslo University Hospital pays non établi dans la noticeÉtablissement de santé
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University of Fort Hare Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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Sefako Makgatho Health Sciences University Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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School of Health Systems and Public Health University of Pretoria, Afrique du Sud (pays nommé en fin d’affiliation)Université ou école supérieure
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Parirenyatwa Group of Hospitals Harare, Zimbabwe (pays nommé en fin d’affiliation)Établissement de santé
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University in Oslo and Womens' Clinic Institute of Clinical Medicine pays non établi dans la noticeUniversité ou école supérieure
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Faculty of Dentistry and Oral Health Hospital Pretoria, Afrique du Sud (pays nommé en fin d’affiliation)Université ou école supérieure
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Faculty of Health Sciences Afrique du Sud (pays nommé en fin d’affiliation)Université ou école supérieure
Department of Obstetrics and Gynaecology — University of Pretoria (University of Pretoria, Afrique du Sud), Parirenyatwa Hospital (Zimbabwe) et Oslo University Hospital, avec 7 autres affiliations. Pays d’affiliation : Afrique du Sud, Zimbabwe.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.