title: An exploration of opportunities and challenges facing cervical cancer managers in Kenya.
abstract: BACKGROUND
  Kenya like other developing countries is low in resource setting and is facing a number of challenges in the management of cervical cancer. This study documents opportunities and challenges encountered in managing cervical cancer from the health care workers' perspectives. A qualitative study was conducted among cervical cancer managers who were defined as nurses and doctors involved in operational level management of cervical cancer. The respondents were drawn from four provincial hospitals and the only two main National public referral hospitals in Kenya. Twenty one [21] nurse managers and twelve [12] medical doctors were interviewed using a standardized interview guide. The responses were audio recorded, transcribed verbatim and the content analyzed in emerging themes.
  
  
  RESULTS
  Four themes were identified. Patient related challenges included a large number of patients, presenting in the late stage of disease, low levels of knowledge on cancer of the cervix, low levels of screening and a poor attitude towards screening procedure. Individual health care providers identified a lack of specialised training, difficulty in disclosure of diagnosis to patients, a poor attitude towards cervical cancer screening procedure and a poor attitude towards cervical cancer patients. Health facilities were lacking in infrastructure and medical supplies. Some managers felt ill-equipped in technological skills while the majority lacked access to the internet. Mobile phones were identified as having great potential for improving the management of cervical cancer in Kenya.
  
  
  CONCLUSIONS
  Kenya faces a myriad of challenges in the management of cervical cancer. The peculiar negative attitude towards screening procedure and the negative attitude of some managers towards cervical cancer patients need urgent attention. The potential use of mobile phones in cervical cancer management should be explored.
authors.affiliation: School of Nursing Sciences, University of Nairobi, PO BOX 19676-KNH-00202, Nairobi, Kenya. lukibitok@uonbi.ac.ke
authors.forename: Lucy W
authors.initials: LW
authors.lastname: Kivuti-Bitok
authors.forename: Ganesh P
authors.initials: GP
authors.lastname: Pokhariyal
authors.forename: Roudsari
authors.initials: R
authors.lastname: Abdul
authors.forename: Geoff
authors.initials: G
authors.lastname: McDonnell
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D040421:Cell Phone; D003142:Communication; D003466:Cultural Characteristics; D003906:Developing Countries; D019468:Disease Management; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006293:Health Promotion / Q000379:methods; D006301:Health Services Needs and Demand; D006801:Humans; D007630:Kenya; D008297:Male; D008403:Mass Screening / Q000379:methods; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control* / Q000628:therapy