Evaluation of cervical cancer prevention plan in a remote rural area in Bolivia

Abstract

Objectives: Evaluate the cervical cancer prevention programme in Roboré as an example of a remote rural area of Bolivia, and identify its main strengths and weaknesses in order to formulate recommendations. Materials and methods: Cross-sectional descriptive study using a combination of methods: analysis of indicators related to screening coverage, treatment opportunities, and vaccination coverage during 2018 and 2019; questionnaire to users of the screening programme on their knowledge, attitudes and practices; questionnaire to professionals involved in the screening programme about the strengths and weaknesses of the programme. Results: Screening coverage was low (41-46%) in the last 2 years, as was the opportunity for treatment (13-16.7%). Vaccine coverage was high (92-98%). After interviewing 82 users, it was shown that a greater knowledge of cervical cancer is associated with a higher level of education and a higher frequency of cytologies. Women have a positive attitude towards vaccination despite poor knowledge of human papillomavirus (HPV) and the vaccine. Health professionals report having committed but limited staff, lack of infrastructure and the need to increase awareness campaigns. Conclusions: We recommend increasing the number of awareness campaigns and mobile screening strategies, having separate offices to carry out cytologies, increasing the staff in charge of the programme and improving the follow-up of women.