Speaker
Description
Cervical cancer screening is the third most common cancer among women. Though evidence showed the high effectiveness of population-based screening programme in reducing the burden of this disease, only 20 out of 28 European Union Member States reported to have population-based screening programme in place in 2017. It is well known that many of the existing programmes in Europe are poorly organized and the most vulnerable women remain hard-to-reach, which increases health inequalities. The EU H2020-funded project CBIG-SCREEN aims to reduce this gap by implementing cervical cancer screening strategies (CCS) that have been co-constructed by and tailored for vulnerable women. To be able to pilot these strategies, a deeper understanding of the country’s contexts would be the first step. Such context assessment includes evaluation of the barriers and facilitators to access screening services as well as the capacity of the health system to implement and sustain changes. We conducted a capacity assessment in the three intervention countries – Estonia, Portugal, and Romania – from October 2021 to July 2022.
The capacity assessment related to implementation of new strategies to improve screening of vulnerable women was divided in three steps. First a desk review assessing the countries policies and guidelines related to cervical cancer screening and vulnerable women was conducted. Then, we performed facility visits in screening and colposcopy centres in the three countries. Finally, key informants were identified, and interviews were conducted to understand key institutions climate.
Data from the facility visits were analysed using R software and lead to a readiness score in 8 dimensions – infrastructure, equipment and supplies, services, staffing, data management, procurement, infectious control, and follow-up. Interviews were transcript and coded using the CFIR codebook for implementation readiness climate. A mixed-method analysis plan was followed to assess the strengths, weakness, opportunities, and threats (SWOT) in each country. The results of the SWOT analysis will help the stakeholders in each country to prioritize intervention and implementation strategies to develop. It will further guide how we should monitor and assess the effects of the tailored strategy that will be pilot tested.
