A community-based model for cervical cancer prevention in Ohangwena and Kavango west regions, Namibia.

Abstract

Background Cervical cancer remains one of the leading causes of cancer related morbidity and mortality among women in Namibia, particularly in rural settings where access to preventive and screening services is limited. Despite national efforts through the Ministry of Health and Social Services to implement the Cervical Cancer Prevention and Control Policy in 2018, service uptake remains low due to social, behavioural, and systemic constraints. This study sought to develop a community-based prevention model for cervical cancer management that integrates community empowerment, health system responsiveness, as well as policy support to strengthen cervical cancer prevention in the Ohangwena and Kavango West regions of Namibia. Methods The study adopted an inductive theory-generating design. Moreover, it was implemented in three sequential phases, adopting a multi-method approach. Phase I entailed a quantitative cross-sectional survey that assessed community members’ knowledge, attitudes, as well as practices regarding cervical cancer prevention. Phase II and III employed an exploratory design to explore women’s health-seeking behaviour that influences the uptake of prevention services, moreover, to examine health system constraints in cervical cancer prevention. Furthermore, data was collected through structured questionnaires, focus group discussions and in-depth interviews, and analysed employing SPSS v29 and ATLAS.ti v23. Findings across the three phases were synthesised to generate key concepts, relationships, and propositions that informed the development of the community-based prevention model for cervical cancer management. Results The study revealed substantial gaps in knowledge and preventive practices of rural communities despite generally positive attitudes toward cervical cancer screening. More importantly, misconceptions, fear of positive results, as well as limited male involvement were prominent impediments to health-seeking behaviour. Furthermore, system-level constraints, including inadequate infrastructure, stock-outs of screening supplies, limited trained personnel, and weak referral systems, further impeded programme effectiveness. However, strong community leadership structures, peer support networks, as well as increasing awareness of women’s health rights emerged as critical facilitators of change. The integration of these findings led to the conceptualisation of a six-component model grounded in policy and financing, research, decentralized governance, equitable and integrated care, capacity building, resilience, and supply chain management, all linked by facilitators such as people-centred care, community empowerment, partnership, and advocacy. Conclusion: This study concludes that achieving a cervical-cancer-free Namibia requires coordinated initiatives that merge community engagement with systemic reform. Moreover, while policy frameworks exist, their translation into context-specific and community-driven interventions remains limited. More importantly, the proposed community-based prevention model provides a practical and adaptable framework for guiding programme design, implementation, as well as evaluation of cervical cancer prevention initiatives in rural Namibia. It emphasises empowerment, inclusivity, and sustainability, offering policymakers and practitioners an avenue to enhance early detection, improve service utilisation, and ultimately reduce cervical cancer growth.