title: Challenges of providing cervical cancer prevention programs in Iran: a qualitative study.
abstract: BACKGROUND
  Cervical cancer has become a major public health problem worldwide. Iran, like other developing countries, is facing a number of challenges in managing the disease. This qualitative study documents challenges encountered in cervical cancer preventing programs in Iran.
  
  
  METHODS
  In-depth interviews were conducted with 28 participants including eleven patients with cervical cancer, three gynecologic oncologists, five specialists in Obstetrics and Gynecology, five midwives, three health care managers and one epidemiologist in Mashhad Iran, between May and December of 2012. The sample was selected purposively until data saturation was achieved. Data credibility verified via allocated sufficient time for data collection, using member checking and peer debriefing. Data analysis was carried out using conventional content analysis approach with ATLAS. ti software.
  
  
  RESULTS
  Findings from data analysis demonstrated 2 major themes and 6 categories about challenges of providing cervical cancer prevention programs including: individual and social challenges (cognitive/behavioral challenges and socio/cultural challenges) and health system challenges (stewardship, financing, competency of health care providers and access to services). Each category included some subcategories.
  
  
  CONCLUSIONS
  Managing the cervical cancer prevention programs need to include the consideration of individuals, health care providers and health system challenges. Addressing the low level of knowledge, negative attitudes, socio cultural challenges, Poor intersectional collaboration and coordination and intra-sectional management, financing and competency of health care providers are essential steps toward significantly reducing the burdens of cervical cancer.
authors.affiliation: Nursing and Midwifery School, student research committee, Mashhad University of Medical Sciences, Mashhad, Iran E-mail : ebrahimipoiurh@mums.ac.ir.
authors.forename: Roghieh
authors.initials: R
authors.lastname: Bayrami
authors.forename: Ali
authors.initials: A
authors.lastname: Taghipour
authors.forename: Hossein
authors.initials: H
authors.lastname: Ebrahimipour
mesh_terms: D002983:Clinical Competence; D003469:Culture; D055088:Early Detection of Cancer; D005260:Female; D005102:Health Expenditures; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007492:Iran; D065006:Papanicolaou Test; D036301:Qualitative Research; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears