Evaluation of the national cervical cancer screening program in Morocco: achievements and challenges
| Autor: | Youssef Chami Khazraji, Richard Muwonge, Loubna Abousselham, Partha Basu, Rengaswamy Sankaranarayanan, Eric Lucas, Farida Selmouni, Latifa Belakhel, Catherine Sauvaget |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Quality Assurance Health Care business.industry Health Policy Public Health Environmental and Occupational Health Uterine Cervical Neoplasms Health Promotion Focus Groups Uterine Cervical Dysplasia Cervical cancer screening Morocco 03 medical and health sciences Outcome and Process Assessment Health Care 0302 clinical medicine Colposcopy 030220 oncology & carcinogenesis Family medicine Humans Mass Screening Medicine Female 030212 general & internal medicine business Early Detection of Cancer Program Evaluation |
| Zdroj: | Journal of Medical Screening. 26:162-168 |
| ISSN: | 1475-5793 0969-1413 |
| DOI: | 10.1177/0969141318824627 |
| Popis: | Objectives To report the key outcomes of evaluation of the national cervical cancer screening program in Morocco, and describe its organization, status of implementation, performance, and major challenges. Methods An evaluation team conducted program manager interviews and screening provider focus group discussions, supervisory visits to primary health and diagnostic centers, and review of published documents. Aggregated performance data collected by the Ministry of Health from the screening and diagnostic centers were analyzed. Results Screening is conducted using visual inspection with acetic acid. The program is opportunistic, with no mechanism to identify and invite eligible women. Coverage of the target population was very low (6.6% in 2015 and 7.7% in 2016). Positivity rates were 5.3% and 8.9% in 2015 and 2016 respectively, and varied widely between regions. Detection rate of cervical intraepithelial neoplasia (CIN) 2 or worse in 2016 was very low (0.9/1,000), with more invasive cancers detected than CIN 2/3. Lack of histopathology and treatment facilities at the Cancer Early Detection Centers is a major short-coming, and there is a need for service-provider refresher training. Without a computerized health information system tracking screen positive women, ensuring high treatment compliance and performing regular quality assurance are challenging. Conclusions The screening program in Morocco requires better organization, a pragmatic system of inviting the target population, improved compliance to diagnosis, treatment, and follow-up, improved provider training, better quality assurance systems, and an effective health information system with appropriate linkages for monitoring and evaluation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|