Objective: The aim of this study is to identify the strengths, weaknesses and challenges of the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) by assessing the performance of this program and suggesting strategies for future improvement and expansion
Methods: A mixed qualitative and quantitative method was conducted between September 2015 and April 2016 in China. The qualitative methods include literature review, in-depth interviews, and an expert review in six of the project counties in three provinces. Quantitative data collection was completed through questionnaire surveys of different stakeholders in these project counties.
Results: Although there were some weaknesses and threats – low screening coverage rate, insufficient compensation, shortage of competent health care personnel, low knowledge of cervical cancer prevention among target women and rapid increase in migration from rural to urban areas – to effective implementation of NCCSPRA, the SWOT analysis also revealed there were many strengths and opportunities on which to move forward. They include increasing of coverage rates, gradual improvement of service capacities, use of more appropriate screening tests, government recognition of the importance of women’s health, constant improvement of medical security and establishment of a screening network.
Conclusion: The effectiveness of an organized cervical cancer screening program is not only influenced by internal factors (strengths and weaknesses) but also by external factors (opportunities and threats). Therefore, in order to improve the implementation of the program in China, multi-strategy actions need to be considered to strengthen the advantages, seize the opportunities, overcome the weaknesses and confront the threats.