Influencing Women’s Actions on Cervical Cancer Screening and Treatment in Karawang District, Indonesia

Introduction: The impact of cervical cancer prevention programs depends on persuading women to gofor screening and, if needed, treatment. As part of an evaluation of a pilot project in Indonesia, qualitativeresearch was conducted to explore the factors that influence women’s decisions regarding screening andtreatment and to generate practical recommendations to increase service coverage and reduce loss tofollow up.
Methods: Research was conducted at 7 of the 17 public health centers in Karawang Districtthat implemented the pilot project. Interviews and focus group discussions were held with 20 women, 20husbands, 10 doctors, 18 midwives, 3 district health officials, and 16 advocacy team members.
Results:Free services and mobile outreach events encouraged women to go for screening, along with promotionalefforts by community health workers, advocacy teams, and the mass media. Knowledge and perceptionswere the most important barriers to screening: women were not aware of cervical cancer risks, did notknow the disease was treatable, and were fatalistic. Factors facilitating treatment were social support fromhusbands, relatives, and friends and the encouragement and role modeling of health workers. Barriersto prompt treatment included limited access to services and the requirement for husband’s consent forcryotherapy.
Conclusion: As cervical cancer prevention services are scaled up throughout Indonesia, thefindings suggest three strategies to expand screening coverage and ensure prompt treatment: strengtheningcommunity mobilization and advocacy activities, modifying the service delivery model to encourage a singlevisit approach to screening and treatment, and working to gain men’s support.