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Table 2 Components of the PARACAO implementation strategy, underlying theories and assumptions

From: Implementation of HPV-based screening in Burkina Faso: lessons learned from the PARACAO hybrid-effectiveness study

Component

Description

Theory

Assumption

Integration of healthcare services

Through the process of implementation, healthcare providers and implementers decide on modifications to existing systems, structures, or tasks to offer women the possibility of having an HPV test at the primary healthcare center

Continuum of care for sexual and reproductive health services [11,12,13]

Integrating HPV testing within primary care enhances both cervical cancer screening and sexual/reproductive health services uptake

Education of healthcare providers

Off-site training of healthcare providers to update their knowledge, persuade them to change their practices, and maintain their competence

Cognitive and learning theories [14]

Education favors the integration of new practices in healthcare settings and improves the quality of cervical cancer screening

Outreach educational visits

A trained supervisor visits each target provider at participating facilities to explore problems, identify possible local solutions, and discuss their concerns

Health promotion, innovation, and social marketing theories [15]

Regular supervisory visits to healthcare providers to help maintain their skills and performance

Patient counseling

Midwives deliver counseling to women at various steps of the screening process: before HPV testing, after the results, after triage and after appropriate treatment if relevant

Women empowerment [16]

Counseling by a trained midwife benefits woman by facilitating a process of informed participation in the context of improved knowledge