Using a multimethod approach to develop implementation strategies for a cervical self-sampling program in Kenya

Area of Science:

• Public Health
• Health Policy
• Implementation Science

Background:

• Health policymakers and researchers face challenges in applying research to policy and implementing practical solutions.
• The Chaguo Letu project aimed to address this gap by exploring how local decision-makers can use a multimethod approach for strategic decision-making.
• The focus was on effectively implementing a Cervical Self-Sampling Program in Kenya.

Purpose of the Study:

• To determine how local decision-makers could apply a multimethod approach to make strategic decisions.
• To effectively implement a Cervical Self-Sampling Program in Kenya.
• To identify factors impacting the implementation of cervical self-sampling.

Main Methods:

• A multimethod approach including participatory action research, scenario-based planning, and phenomenology was employed.
• 107 stakeholders participated in various data collection methods like interviews and focus groups.
• Data analysis involved content analysis, affinity exercises, and impact analysis to develop strategic directions.

Main Results:

• 57 factors impacting program implementation were identified and categorized into 13 themes.
• 10 strategic directions and 22 implementation strategies were developed.
• These strategies aimed to ensure the program was technically viable, politically supported, affordable, feasible, socially acceptable, and transformative.

Conclusions:

• Political will exists for improved cervical screening in Kenya, but resource constraints are a challenge.
• Cervical self-sampling is logistically feasible in urban/rural settings, though subsidies are needed for affordability.
• Self-sampling is perceived as more socially acceptable than current Pap screening methods, offering a pathway for broader implementation.