title: Systems analysis of real-world obstacles to successful cervical cancer prevention in developing countries.
abstract: Papanicolaou screening is feasible anywhere that screening for cervical cancer, the leading cause of cancer-related death among women in developing countries, is appropriate. After documenting that the Vietnam War had contributed to the problem of cervical cancer in Vietnam, we participated in a grass roots effort to establish a nationwide cervical cancer prevention program in that country and performed root cause analyses of program deficiencies. We found that real-world obstacles to successful cervical cancer prevention in developing countries involve people far more than technology and that such obstacles can be appropriately managed through a systems approach focused on programmatic quality rather than through ideological commitments to technology. A focus on quality satisfies public health goals, whereas a focus on technology is compatible with market forces.
authors.affiliation: Department of Pathology, Kaiser Permanente Medical Center, 1200 El Camino Real, South San Francisco, CA 94080, USA. eric.suba@kp.org
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Suba
authors.forename: Sean K
authors.initials: SK
authors.lastname: Murphy
authors.forename: Amber D
authors.initials: AD
authors.lastname: Donnelly
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Furia
authors.forename: My Linh D
authors.initials: ML
authors.lastname: Huynh
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Raab
mesh_terms: D003906:Developing Countries; D005260:Female; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D008403:Mass Screening / Q000458:organization & administration*; D065006:Papanicolaou Test; D015980:Public Health Practice; D013598:Systems Theory; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control* / Q000628:therapy; D014626:Vaginal Smears; D014932:Women's Health Services / Q000458:organization & administration