Cervical cancer screening status and implementation challenges: Report from selected states of India

Abstract

Background: Cervical cancer contributes to 6%–29% of the cancers in India. Although the Government of India in 2010 integrated cancer screening within the National Programme for the prevention of Non‐communicable Diseases, only 22% of women aged 15–45 years had undergone examination of the cervix by 2016. This prompts the question regarding the organisation of the program's implementation and service delivery and regarding challenges that may explain poor screening uptake. Methods: Semi‐structured interviews were held with program managers and implementers in seven districts of three selected States of India. The data analysis looked at program content, the organisation of screening delivery, and the challenges to the implementation of the program, considering six theoretically derived dimensions of public health capacity: leadership and governance, organisational structure, financial resources, workforce, partnerships, and knowledge development. Results: Participants perceive the existing capacities across the six domains as insufficient to implement the CCS program nationwide. A context specific implementation, a better coordination between the program and district health facilities, timely remuneration, better maintenance of data and a strong monitoring system are possible solutions to remove health system related barriers. Conclusion: The study provides evidence on the practical challenges and provides recommendations for strengthening the capacities of the health system.