Barriers and Facilitators to the Implementation of the Weekend-70 Cervical Cancer Screening Programme in Mali: A...

Cervical cancer (CC) represents a significant public health issue in low- and middle-income countries. In Mali, the Weekend-70 cervical cancer screening programme, initially implemented in Bamako (the capital), is gradually being rolled out in other regions. Based on the visual inspection screening method, the programme aims to reduce mortality and morbidity due to CC. This article analyzes the barriers and facilitators influencing the programme's implementation in semi-urban and rural health centres.

Using a multiple-case study comparing the Kayes Ndi and Konobougou health centres, we conducted 18 semi-structured interviews. Participants were key stakeholders in the implementation of the programme and included health centre staff (healthcare professionals, matrons, midwives and managers) as well as programme users. A thematic content analysis was carried out using QDA Miner Lite.

The results show that the main barriers to implementing the programme are the lack of resources (human and material), the lack of training (initial and continuous) and the limited involvement of religious groups, considered as community pillars. The main facilitators identified were the offer of free screening days, favourable collaboration (between health centre staff and with their partners), awareness-raising and the availability of on-site treatment.

This study highlights the need to consider the barriers and facilitators influencing implementation to improve the programme, particularly with a view to national scaling. Our recommendations could guide programme managers and decision-makers in this process, as well as benefiting other sub-Saharan African countries wishing to implement similar programmes.