Healthcare providers’ perspectives on factors influencing the implementation of the screen and treat single-visit approach for cervical cancer screening in Ilala Municipal Council, Dar es Salaam, Tanzania: a qualitative study

Abstract

Abstract Background Cervical cancer is a leading cause of cancer-related deaths among women in Tanzania. To address this burden, the Ministry of Health adopted the Screen and Treat Single-Visit Approach (ST-SVA), which involves screening with Visual Inspection using Acetic Acid (VIA) and providing same-day treatment for precancerous lesions. Despite its effectiveness, little is known about the factors influencing its implementation from the perspective of healthcare providers in urban Tanzanian settings. Objective To explore healthcare providers’ perspectives on factors influencing the implementation of the Screen-and-Treat Single Visit Approach (ST-SVA) for cervical cancer screening in two high-volume health facilities in Ilala Municipal Council, Dar es Salaam, Tanzania. Methods A qualitative phenomenological design was employed to two health facilities that is Mnazi Mmoja Hospital and Amana Regional Referral Hospitals in Ilala Municipal Council, Dar es Salaam. A qualitative approach was considered appropriate because implementation factors are often shaped by contextual and experiential influences, requiring an in-depth exploration of healthcare providers’ perceptions and lived experiences. Results Findings from the two study facilities revealed four interrelated themes influencing implementation of the ST-SVA. First, providers demonstrated varied interpretations of national screening guidelines, at times extending screening services to younger women perceived to be at higher risk. Second, client-related barriers affected uptake of same-day treatment, particularly concerns about post-treatment abstinence, fear and misconceptions surrounding cryotherapy, and the influence of peers and family members. Third, gaps in healthcare provider capacity and readiness were evident through limited refresher training, staff shortages, and reliance on on-the-job learning. Finally, broader health system constraints including dependence on donor-supported supplies and recurrent equipment maintenance failures, disrupted continuity of cervical cancer screening and treatment services. Conclusion This study suggests that implementation of the ST-SVA in the two facilities is shaped by interconnected provider, client, and health system factors. Strengthening provider training, enhancing community and partner education, and securing sustainable domestic procurement systems are prioritized actions for improving cervical cancer prevention.