Improve the quality and coverage of National Cervical Cancer Screening programme by exploring healthcare workers' acceptability, relevance, simplicity and barriers for new HPV/DNA test in a district of Sri Lanka: A cross sectional qualitative study

Background Even after 20 years of cervical cancer screening with pap smears, there is no marked reduction in the incidence of cervical cancer in Sri Lanka. The objective of the study was to improve the quality and coverage of the National Cervical Cancer Screening programme by exploring healthcare workers' acceptability, relevance, simplicity and barriers for new HPV/DNA test in a district of Sri Lanka. Method A cross-sectional qualitative research method was used.Four Focus group discussion sessions and ten In-depth interviews were conducted to collect data. According to the seniority and the sector of representation eight Public Health Midwives were selected for one FGD session from the Medical Officer of Health areas. Among the healthcare workers, who actively engaged in the cervical cancer screening programme, 10 Key Informants were selected. To select participants a convenient sampling technique was used. To improve the quality of the study a Triangulation methodology was used. Broad themes and categories were identified and finally, summary results were prepared accordingly. The manual content was used in the analysis. Results Among the healthcare workers’ majority were Sinhalese (n=41, 97.6%), Buddhist (n=39, n=92.9%), and over 40 years of age (n=31, n=73.8%). Fourteen (n=33.3%) had >20 years of service in the field. Low sensitivity of conventional cytology, unsatisfactory smears, and reporting delay were stated by some as disadvantages of the pap smear screening method. Healthcare workers expressed high acceptability (n = 41, 97.62%) for HPV/DNA test due to it’s high sensitivity. Majority stated the convenience of vaginal specimens (n=22, 52.4%) as a cervical cancer screening tool to improve the coverage of the programme. Conclusions HPV/DNA tests can be used to improve the quality of the programme. In addition, the vaginal HPV/DNA tests can be used as a newcervical cancer screening tool to increase the coverage of the programme.