Cervical cancer prevention and control strategy in Ethiopia: Key informant Clinician’s perspective

Background : Cervical cancer is a major public health burden in Ethiopia, ranking second among women and disproportionately affecting HIV-positive individuals. In 2020, an estimated 7,445 new cases and 5,338 deaths occurred. Thus, accurate diagnosis, treatment, and palliative care can reduce mortality and improve quality of life, necessitating exploration of challenges and gaps in prevention and control strategies from frontline expert clinicians’ perspectives. Methods: A qualitative study design using a descriptive phenomenology strategy was employed to collect data from eight experienced clinicians selected purposively from eight governmental hospitals with a large client flow of HIV patients rendering cervical cancer screening services between September and October 2021 in Ethiopia. Semi-structured pre-tested interview guides or probing questions were used to interview the key informants. The interviews took 45 minutes on average. The collected data was then organized, coded, and analyzed thematically. Results : Key findings highlighted the implementation of health education, provider training, as primary prevention and screening using visual inspection with acetic acid (VIA) and cryotherapy as secondary prevention strategies. Challenges included lack of awareness among women (both HIV positives and negatives), staff burnout, inconsistent screening algorithms, and difficulties in follow-up of positive cases. Recommendations emphasized strengthening awareness through multi-modal approaches, assigning dedicated screening staff, expanding screening access, improving follow-up systems, and addressing socio-cultural barriers. Self-sampling was perceived favorably to increase screening uptake by overcoming fears and privacy concerns, though quality assurance was noted as crucial. High loss to follow-up was attributed to the asymptomatic nature of cervical cancer and lack of awareness about its severity. Conclusion: Findings underscore the need for comprehensive strategies to enhance early detection, treatment access, and community engagement to reduce the substantial cervical cancer burden, particularly among high-risk HIV-positive women.