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All Journal Jurnal Kedokteran Syiah Kuala Jurnal Kedokteran Brawijaya Sari Pediatri Padjadjaran Journal of Dentistry Jurnal Ilmiah Mahasiswa Kedokteran Medisia Jurnal Penelitian dan Pengabdian Kepada Masyarakat UNSIQ Jurnal Sinaps Poltekita : Jurnal Ilmu Kesehatan Indian Journal of Forensic Medicine & Toxicology Narra J Journal of Medical Science; Jurnal Ilmu Medis Rumah Sakit Umum Daerah dr. Zainoel Abidin, Banda Aceh International Journal Of Public Health Media Penelitian dan Pengembangan Kesehatan
Rachmad Suhanda
Fakultas Kedokteran Universitas Syiah Kuala
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Other

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Multi-stakeholder perspectives on cervical cancer screening implementation in Indonesia: A qualitative study of cervical screening barriers in Banda Aceh Yolanda, Febrina; Dewi, Tgk. Puspa; Nainggolan, Sarah I.; Munawar, Munawar; Munizar, Munizar; Bulqini, Rijal; Suhanda, Rachmad; Rusnaidi, Rusnaidi
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3022

Abstract

Indonesia is committed to the WHO's cervical cancer elimination strategy through the National Action Plan (RAN) 2023–2030, targeting 75% screening coverage by 2030. However, current rates remain critically low at 7.02%. This study explores multi-stakeholder perspectives to identify implementation barriers and facilitators for policy enhancement. A qualitative descriptive case study was conducted in Banda Aceh (July-August 2025) involving 25 stakeholders: City Health Office Head, 11 puskesmas heads, 11 VIA coordinators and 2 community organization representatives. Thematic analysis using NVivo v.16 identified key implementation factors. Five major themes emerged: (1) Knowledge gaps—screening perceived necessary only when symptomatic despite available information; (2) Access paradox—excellent geographic access and flexibility undermined by limited examination rooms, insufficient midwives, and psychosocial barriers (shame, fear, lack of spousal support); (3) Financial sustainability—free services threatened by complex BPJS claims and low reimbursement affecting logistics; (4) Service quality variation—dependent on cross-sector collaboration and staff competency, with uneven training and limited cryotherapy (only 2 centers); and (5) Communication challenges—inconsistent digital media use necessitates face-to-face counseling and cadres, though reach remains limited. Implementation faces psychological barriers, capacity limitations, and uneven digital adoption despite strong infrastructure. Priority policy recommendations include: (1) HPV DNA self-sampling to overcome privacy barriers; (2) simplified BPJS claims with adequate reimbursement; (3) systematic competency-building and cryotherapy expansion; and (4) culturally-adapted education integrating local language and religious leaders. These evidence-based enhancements could accelerate Indonesia's RAN 2030 elimination targets.
Co-Authors Aditya, Rizka Adnyana, I Gde Hary Eka Agung Pranata Aini, Zahratul Atika, Siti Azka Muda Adri Bulqini, Rijal Chairunas Chairunas Cut Fauziah Dessy R. Emril Dewi, Tgk. Puspa Dian Lestari, Nova Djazuly Chalidyanto Dwi Susanti, Nurhayani ENDANG MUTIAWATI, ENDANG Evrillisa, Ghina Alya Fadhlia Farida Farida Febrina Yolanda FIRDAUSA, SARAH Fitria, Sova Geumpana, Teuku A. Hendra Zufry, Hendra Irwan Saputra Ismy, Dewi Purnama Sari Juwita Kurnia , Benny Kurnia Fitri Jamil Laurentina, Yoriko Liza Meutia Sari M. Yogi Riyantama Isjoni Machillah, Nurul Maimun Syukri, Maimun Marty Mawarpury Mellazulfa, Dhea Sofiana Munizar Munizar, Munizar Mustaqiem Isda Nainggolan, Sarah I. Nurfianto, Sigit Nurwijayanti Oktaria Denantika Purnama, Dean R. Refani, Priska Renaldi, Teuku Rima Novirianthy Rovy Pratama, Rovy Rusnaidi Said Usman Sembiring, Thyrister Nina Asarya Setiani, Lily Sinta, Gian Salsabila Soehartati Gondhowiardjo Sukri Ekadamayanti, Agustia T. Maulana Tristia Rinanda Usman Hadi Utami, Niken A. Wardhana Sucipto, Krishna Widodo J. Pudjirahardjo Yeni Yeni Yuarta, Ferina Agustia Yus, Teuku Muhammad Zainul Abidin, Siti Nur Nabihah Zakaria, Iskandar Zulkarnain Zulkarnain