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Table 3 Challenges to health seeking and cervical cancer care in Gulu

From: Mind the gaps: a qualitative study of perceptions of healthcare professionals on challenges and proposed remedies for cervical cancer help-seeking in post conflict northern Uganda

Challenges in cervical cancer care Respondents by hospital and gender N
  Public hospital Mission hospital  
  Male Female Male Female  
A. Individual and community related challenges      
Lack of awareness amongst women; Inadequate sensitization and mobilization of communities R5 R1, R3, R4 R11 R7, R8, R9 8
Late stage disease at presentations and its management challenges R5, R6 R2, R3, R4, R14 R11 R7, R8, R10, R15 11
Inadequate psychosocial support to and abandonment of patients by relatives R6    R7, R10, R15 4
Fear of exposure (undressing and lying in lithortomy position) and perceived pain from speculum during screening   R3 R13 R15 3
Complaints against/Stigma from other patients because of smell from cervical cancer patients   R3    1
Patients cannot pay for services such as histology and EUA R6   R11 R10, R15 4
Refusal to consent     R7, R9, R15 3
Inadequate contact address of patients and hence poor follow up to let results known to them R5   R11   3
B. Individual health professional related challenges      
Inadequate knowledge and skills in cervical screening, cervical cancer diagnosis and care R5, R6 R1, R2, R3, R14 R10, R11, R12, R13 R7, R8, R15 13
C. Health system related challenges      
No pathologist and no Pap smear test R5, R6 R1   R15 4
No gynecologists or doctors in gynecology department to supervise screening, do biopsy, do operations R5, R6 R1, R2, R4    5
Delayed histology results and or specimens/results getting lost R6 R2, R3   R10, R15, 5
Inadequate space/ward for cervical cancer patients   R3 R12   2
Abandonment of histology results R5   R11   2
Long distance to and lack of transport to screening points   R4, R14   R10 3
Congestion at screening, long waiting time to screening, scheduling delay    R11 R7 2
Lack of formalin for biopsies   R2    1
Few nurses and midwives to support screening and health talk to women   R3, R14   R15 3
Lack of blood for transfusion before and during operations    R12 R15 2
Stock out of morphine and inadequate pain control     R7, R10 2
Hospital does not provide food to the patients who stay for long and run out of money and support R6 R3, R4, R14   R10 5
Inadequate labeling of clinics and lack of integration of services R5     1
Poor reputation of hospital and inhibiting health seeking there R5     1
Men health workers doing screening     R7, R15 2
D. Health policy related challenges      
Lack of vaccination against HPV R5 R1, R2 R11,R12, R13 R15 7
Radiotherapy is very far and patient cannot afford transport and cost of care in city R6 R14    2
  1. Note: R1, R2 = Respondents’ order of interview as on Table 2.