ArticleBMC public health2025
Barriers and contributions of rural community health workers in enabling cancer early detection and subsequent care in India: a qualitative study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Community health worker-supported oral health promotion in low- and middle-income countries: a scoping review of roles, interventions, and outcomes.BMC public health · 2026Article
- Barriers to help-seeking for cancer in India: A scoping review.The Indian journal of medical research · 2026Article
- From evidence to action: the IARC's role in strengthening cancer prevention and early detection.Journal of the National Cancer Institute. Monographs · 2026Review
- Reimagining community health nursing: a qualitative participatory action research study of nurse-led primary healthcare innovation in rural Saudi Arabia.BMC nursing · 2026Article
- Barriers and facilitators to cancer care in the Northeast region, India: A scoping review.The Indian journal of medical research · 2026Article
- Leveraging the role of families in decision-making to inform a program of HPV-based self-collection for cervical screening in Tamil Nadu, India: a qualitative study.Cancer causes & control : CCC · 2026Article
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- A Report from a Community-Centric Cancer Control Approach in the Post-Conflict Northern Province of Sri Lanka.International journal of environmental research and public health · 2025Article
- Predicting and identifying correlates of inequalities in breast cancer screening uptake using national level data from India.Frontiers in artificial intelligence · 2025Article
- Qualitative research in oral health in India: A bibliometric analysis.Journal of oral biology and craniofacial researchReview
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Abstract
backgroundThe cancer burden in India is escalating, with rural regions facing the greatest challenges in access to early detection and treatment. Community Health Workers (CHWs), such as Accredited Social Health Activists (ASHAs), Village Health Nurses (VHNs), and Auxiliary Nurse Midwives (ANMs), play a critical role in bridging these healthcare gaps. This study explores the barriers and contributions of CHWs while facilitating early detection and subsequent care in selected rural areas of India.
methodsThis qualitative study is part of the Access Cancer Care India (ACCI) implementation research project, conducted in three states: Rajasthan, Kerala, and Tamil Nadu. We conducted six focus group discussions (FGDs) with 47 CHWs, representing various health cadres, to investigate their experiences and the barriers they face in delivering cervical, breast and oral cancer care. The discussions were analyzed using Charmaz's Grounded Theory approach, with axial coding and constant comparative analysis until data saturation was reached.
resultsCHWs identified multiple barriers to cancer early detection and subsequent care delivery, organized into six overarching themes: (1) Program focus and awareness, (2) Treatment and referral challenges, (3) Acceptability and accessibility, (4) Rigid social customs and beliefs, (5) Lack of support at higher centers, and (6) Financial constraints. A lack of formal training, poor infrastructure, negative communication, fear of diagnosis, and financial burdens were among the major barriers highlighted. CHWs from Tamil Nadu and Kerala, where sporadic screening initiatives exist, reported better preparedness compared to their counterparts in Rajasthan. Additionally, the CHWs outlined the vital role of positive word-of-mouth and community engagement in improving cancer screening participation.
conclusionsCHWs in rural India face significant personal, community, and health system barriers while facilitating cancer early detection services and subsequent follow up. Addressing these barriers through tailored training, enhanced health infrastructure, and community-based interventions can improve cancer care access and outcomes in rural settings. Future policies should focus on strengthening CHW-led approaches and addressing the systemic barriers in cancer care delivery.
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