Towards the elimination of cervical cancer in Tanzania, transdisciplinary science for smarter implementation strategies (TRACCTION): a mixed methods study protocol

ABSTRACT

Introduction Cervical cancer is the leading cause of cancer-related mortality for Tanzanian women. Multi-level, intersecting factors prevent access to care along the cervical cancer care cascade. However, there is a paucity of data, especially in non-urban areas, exploring the specificity and nuances of these factors locally, such as perceptions and embodied experiences of cervical cancer, use of traditional medicine, stigma, information generation and circulation and loss to follow up care. TRACCTION is an exploratory, mixed-methods study running from 2023-2025 to expand understanding of barriers to and facilitators of uptake of cervical pre-cancer screening and treatment and cervical cancer care in southeastern Tanzania.

Methods and analysis Research activities include a two-stage randomised cross sectional survey of women 18 years of age and older, qualitative data collection using diverse, community-based methods and a longitudinal public health facility record linkage of patients accessing cervical pre-cancer screening and treatment. By employing a transdisciplinary approach, TRACCTION will inform a participatory process to formulate cervical cancer education and policy recommendations.

Ethics and Dissemination This study received ethical approval in Tanzania and Switzerland. Informed written consent will be obtained from each study participant and a waiver of informed consent was obtained to retrospectively analyse public health facility records related to study objectives. A Policy and Technical Advisory Group, comprised of a diverse group of stakeholders including community members, will co-design a policy and service delivery analysis, followed by recommendations and dissemination plans. Study results for each work package will be published in peer reviewed journals and shared at relevant conferences globally.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The study is funded by the Swiss National Science Foundation (SNSF IZSTZ0_208429 / 1, Principal Investigators: Dr. Sonja Merten and Dr. Sally Mtenga). The project is implemented in partnership between the Swiss Tropical and Public Health Institute, an associated institute of the University of Basel, Switzerland, Ifakara Health Institute Dar es Salaam and Ifakara, Tanzania and Kibaoni Health Center, Kibaoni, Morogoro, Tanzania.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Internal Review Board of the Ifakara Health Institute, the National Institute for Medical Research in Tanzania and Ethikkommission Nordwest- und Zentralschweiz in Switzerland gave ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Footnotes

* Co-first authors

gmhaluihi.or.tz, Mari.dumbaughswisstph.ch; mariii-consulting.com, Daniel.kiposwisstph.ch, Magreat.sombaswisstph.ch, dmnzavaihi.or.tz, Julia.bohliusswisstph.ch, smtengaihi.or.tz

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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