Feasibility of HPV self-sampling pathway in Kathmandu Valley, Nepal using a human-centred design approach

Publication Year: 2021
Contributing Organisation: Birat Nepal Medical Trust
Authors: Swastika Shrestha, Saki Thapa, and Paul Sims
Learning Themes: Global Health

Cervical cancer is preventable and curable yet causes almost 2000 deaths in Nepali women each
year. The present study aims to explore the feasibility and acceptability of a self-sampling-based approach
for cervical cancer screening in urban and peri-urban Nepal and develop pathways for self-sampling using a
co-design methodology. An iterative design approach was applied. Semi-structured in-depth interviews were
conducted with 30 healthy women and four women who had had a prior cancer diagnosis on topics which
included: sexual and reproductive health knowledge and human papillomavirus (HPV); use of the internet/
social media platforms; their views regarding acceptability and usability of the self-sampling kit and the
proposed user journey.
Data collection was done between December 2020 and January 2021. Seven medical
experts were also interviewed to explore the current service configuration for cervical cancer screening in
Nepal. Knowledge regarding HPV and its association with cervical cancer was absent for the majority of
participants. Although 70% (n = 21/30) had purchased items online previously, there was a general lack of
trust in online shopping. Half of the women (n = 17/30; 56.7%) expressed a willingness to self-sample and
provided recommendations to improve the clarity of the instructions. The proposed user journey was
considered feasible in the urban area. There is a clear unmet need for information about HPV and
alternative cervical screening options in Nepal. An online pathway for self-sampling service delivery to urban
women is feasible but will need to be optimally designed to address barriers such as confidence in self sampling and trust in online purchasing.

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