Barriers and Facilitators for Increasing Cervical Cancer Screening in Tuvalu

Gianna Robbers, Family Planning Australia
Shannon Rasmussen, Family Planning Australia
Rachel Sandford, Family Planning Australia
Anne Stuart, Family Planning Australia

Cervical cancer (CC) is the fourth most common cancer in women with 90% of cancer deaths occurring in low-and-middle-income countries. CC is preventable if changes are detected early and treated. The global strategy for cervical cancer elimination was adopted in 2020 and set targets to be met by 2030. FPA has partnered with the Tuvalu Family Health Association, the Ministry of Health and Cepheid to implement a screen and treat, point-of-care model using a GeneXpert machine and treatment with thermal ablation. The cervical screening and treatment programme was evaluated in 2023 and included an analysis of screening data and nine stakeholder interviews. Tuvalu is the first country in the Pacific to meet the WHO screening target with over 76% of eligible women screened. Treatment rates were lower at around 58%. Identified barriers included delivery delays in medical consumables and limited outreach due to the remoteness of some islands. Identified facilitators for screening uptake included having the option for women to self-collect HPV DNA samples and conducting community outreach. Self-collected HPV DNA testing is an effective and acceptable method of screening. However, more outreach and education is needed to improve treatment rates. Strategies to address delivery delays need to be considered.

Keywords: Sexual and Reproductive Health and Rights, Population and Development, Mixed methods research, Mortality and Longevity

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