ArticleAsian Pacific journal of cancer prevention : APJCP2026
Indonesian Midwives' Readiness to Upscale the Secondary Prevention of Cervical Cancer within Primary Health Clinics: A Qualitative Study of Midwives Across Three Provinces.
Article in Asian Pacific journal of cancer prevention : APJCP, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis article analyzes the readiness of Indonesian midwives for the rapid scale-up of secondary prevention of cervical cancer, in line with Indonesia's National Plan for Cervical Cancer Elimination (2023-2030).
methodsData were collected via a mixed-methods study conducted in 2024. We analyzed a subset of qualitative data from semi-structured interviews with 24 midwives, sampled from 13 primary health clinics (PHCs) in Kupang City, Purworejo Regency, and Palu City. Thematic analysis revealed four key themes relevant to determining midwives' readiness: knowledge; technical training and confidence in performing visual inspection with acetic acid (VIA); communication skills; and motivation.
resultMidwives' knowledge of causation and risk factors was high, underpinning their high perception of cervical cancer risk and subsequent strong motivation to provide screening. However, inconsistent knowledge existed regarding screening targets, intervals, and clinical indications for screening. Training coverage was low, with only half of the midwives having received training. Multiple midwives viewed their training as inadequate for establishing competency in the interpretation of VIA results, negatively impacting their motivation. Midwives reported high confidence in communication skills but noted a lack of health communication materials for patient education and raised concerns over the suitability of PHC information systems for enabling follow-up.
conclusionThe proportion of Indonesian midwives receiving training in cervical screening and provider-administered HPV DNA testing needs to increase significantly. Training in cervical cancer prevention should receive greater attention in the core curriculum for midwifery accreditation. The content should be more comprehensive, addressing knowledge gaps, low confidence in interpreting VIA results, and the transition to HPV DNA testing. A train-the-trainer program for senior midwives to enable high-quality peer education would be a strategic investment. Critical system-level changes such as adequate budgets, provision of health communication materials, and improvements to the design and use of health information systems are also required.
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