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. 2020 Mar 17;31(5):417–429. doi: 10.1007/s10552-020-01290-4

Table 3.

Demand- and supply-side barriers (ranked by frequency)

Demand-side barriers N % Supply-side barriers N %
26a 51 28* 49
Multiple mentions Provider-specific barriers 22a 78.6
Clinical procedure discomfort 6 23.1 Provider lack of opportunities/time for training 10 45.5
Client lack of knowledge 5 19.2 Provider shortages/turnover 9 41.0
Client embarrassment in the clinical setting 3 11.5 Trained provider having technical deficiency 6 27.3
Cost to client 3 11.5 Trained provider lack of counseling knowledge (psychosocial/resource availability/policy and guidelines awareness) 5 22.7
Distance to the clinic 2 7.7 Trained provider not offering service/competing priorities 3 13.6
Clients having low priority for prevention 2 7.7 Trained provider having technical approach bias 2 9.1
Permission required from husband 2 7.7
Concern about no sexual intercourse after procedure 2 7.7
Single mention System-specific barriers 16a 57.1
Client concern about side effects 1 3.8 Cost to system 9 56.3
Screening is for promiscuous women 1 3.8 Lack of lab resources/malfunctioning equipment 7 43.8
Cervical Cancer is a curse 1 3.8 Facility distance to rural populations 4 25.0
Trust concerns with client-collected sample 1 3.8 Lack of supplies 3 18.8
Client concern about incorrect use of device 1 3.8 Lack of data-driven management 3 18.8
Challenges collecting sample in home environment 1 3.8 Lack of clinical space 2 12.5
Misperception that screening is not a primary concern or reason to visit the clinic (it is a secondary concern) 1 3.8 Lack of clinical supervision 1 6.3
Lack of immediate results 1 3.8 Ineffective referral systems/data management 1 6.3
Challenges with multiple visits or follow-up 1 3.8 Lack of policy/guidelines 1 6.3
Less acceptance in older women 1 3.8 Length of wait time/convenient appointment 1 6.3
Skepticism and Suspicion of the safety and efficacy of screening device, mainly among more educated women 1 3.8 Lack of electricity 1 6.3
Communication and language challenges 1 3.8
Cultural barriers to diseases of reproductive system 1 3.8
Lack of awareness of service availability 1 3.8

aCategories are not mutually exclusive