Overview of Cervical Cancer Prevention Services in Khartoum State – December 2018: A Case Study

Abstract

Background: Although cervical cancer is largely preventable, it continues to be an important cause of morbidity and mortality in Sudan, due to the lack of national control programs. This study aimed to evaluate the availability of cervical cancer prevention services and assess the facility readiness in Khartoum state, as a base for future plans. Methods: This study was an observational, mixed-method, health service research. Purposive sampling method was used to select focal persons to explore the current situation and the available services qualitatively. Observation through standardized checklists of screening and colposcopy centers was conducted, and service providers were interviewed. Thematic analysis and descriptive statistics were used to analyze data. Results: Based on the qualitative interviews, Khartoum Oncology Hospital is the only specialized center providing chemotherapy and radiotherapy services for the state. Although six screening and nine diagnostic centers were surveyed, services were not available in most localities. Reasonable but unutilized resources in the secondary level exist at the time of the study, primary-level efforts to control cervical cancer are uncoordinated and ineffective, with no linked efforts at the community level. Since initiatives to reduce cervical cancer mortality need to adopt a holistic approach to the disease continuum, a comprehensive model was suggested and explained, the gaps and challenges were discussed. Conclusion: Cervical cancer prevention still remains a highly unaddressed need in Sudan. Sustainable financing of robust programs is necessary to achieve elimination. Contextually relevant devices must be selected to improve resource allocation. These results might be useful for the establishment of cervical cancer control in Sudan. Keywords: cervical cancer, screening, health system, developing countries, Sudan