Determinants of access and utilization of cervical cancer treatment and palliative care services in Harare, Zimbabwe

Show simple item record Tapera, Oscar Dreyer, Greta Kadzatsa, W. Nyakabau, A.M. Stray-Pedersen, B. Hendricks, S.J.H. 2020-07-15T08:01:10Z 2020-07-15T08:01:10Z 2019-07-29
dc.description.abstract BACKGROUND : Cervical cancer treatment and care services have remained largely centralized in Zimbabwe thereby entrenching inequities to access amongst patients. The objective of this study was to investigate the determinants of access to treatment and care among women with cervical cancer in Harare, Zimbabwe. METHODS : A sequential explanatory mixed methods design was used. In phase 1, three surveys (namely community, patient and health worker) were conducted with sample sizes of 143, 134 and 78 participants respectively. Validated structured questionnaires programmed in Android tablet with SurveytoGo software were used for data collection during the surveys. Univariate, bivariate and multivariate logistic regression analyzes were conducted using STATA® version 14 to generate descriptive statistics and identify determinants of access to cervical cancer treatment and care. In phase 2, 16 in-depth interviews, 20 key informant interviews and 6 focus groups were conducted to explain quantitative data. Participants were purposively selected and saturation principle was used to guide sample sizes. Manually generated thematic codes were processed in Dedoose software to produce final outputs for qualitative study. RESULTS : Knowledge of causes (p = 0.046), perceptions of adequacy of specialists (p < 0.001), locus of control (p = 0.009), service satisfaction (p = 0.022) and walking as a means of reaching nearest health facilities (p < 0.001) were associated with treatment or perceptions of access by healthy women. Perceptions of access to treatment amongst health workers were associated with their basic training institution (p = 0.046), health service quality perceptions (p = 0.035) and electricity supply status in their respective health facilities (p = 0.036).Qualitative findings revealed health system, societal and individual factors as barriers to accessing treatment and palliative care. CONCLUSIONS : There are numerous prevailing multi-dimensional barriers to accessing cervical cancer treatment and palliative care in a low –income setting. The findings of this study revealed that heath system and societal factors were more important than individual level factors. Multi-sectoral approaches are recommended to address all the multifaceted barriers in order to improve cervical cancer treatment and palliative care access for better outcomes in resource-limited contexts. en_ZA
dc.description.department Obstetrics and Gynaecology en_ZA
dc.description.department School of Health Systems and Public Health (SHSPH) en_ZA
dc.description.librarian am2020 en_ZA
dc.description.sponsorship The Letten Foundation, Norway en_ZA
dc.description.uri en_ZA
dc.identifier.citation Tapera, O., Dreyer, G., Kadzatsa, W. et al. 2019, 'Determinants of access and utilization of cervical cancer treatment and palliative care services in Harare, Zimbabwe', BMC Public Health, vol. 19, art. 1018, pp. 1-15. en_ZA
dc.identifier.issn 1471-2458 (online)
dc.identifier.other 10.1186/s12889-019-7355-3
dc.language.iso en en_ZA
dc.publisher BioMed Central en_ZA
dc.rights © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. en_ZA
dc.subject Cervical cancer en_ZA
dc.subject Access en_ZA
dc.subject Determinants en_ZA
dc.subject Treatment en_ZA
dc.subject Palliative care en_ZA
dc.subject Inequity en_ZA
dc.subject Health system en_ZA
dc.subject Sequential mixed methods en_ZA
dc.subject Zimbabwe en_ZA
dc.title Determinants of access and utilization of cervical cancer treatment and palliative care services in Harare, Zimbabwe en_ZA
dc.type Article en_ZA

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