A qualitative study on ASHA workers' perspective on HPV self-sampling in Sikkim India

Area of Science:

• Public Health
• Oncology
• Health Services Research

Background:

• Cervical cancer remains a significant public health issue in India, with traditional screening methods facing limitations.
• Existing healthcare infrastructure challenges hinder widespread screening program effectiveness.

Purpose of the Study:

• To assess the feasibility and challenges of implementing Human Papillomavirus (HPV) self-sampling by Accredited Social-Health Activists (ASHAs) in Sikkim, India.
• To evaluate the implementation using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.

Main Methods:

• Qualitative analysis of in-depth interviews with 20 ASHA workers involved in HPV self-sampling implementation in Sikkim.
• Data categorized according to the RE-AIM framework.

Main Results:

• Facilitators included participant autonomy, positive community reception, and home-based testing convenience.
• ASHA worker engagement in health education and counseling was vital.
• Successful implementation was aided by training, community trust, and mobile technology for results.
• Barriers comprised low health literacy, ASHA worker logistical issues, and insufficient incentives.

Conclusions:

• HPV self-sampling by ASHAs is a feasible approach for cervical cancer screening in Sikkim.
• Tailored screening, community engagement, and programmatic support are crucial for acceptance.
• Addressing barriers requires multi-level interventions for successful, sustainable implementation.