The Prevention and Screening Innovation Project towards Elimination of Cervical Cancer (PRESCRIP-TEC) research project contributes to the evidence-base for the WHO strategy to eliminate cervical cancer as a public health problem. The project implements an innovative approach in cervical cancer screening, including direct treatment and follow-up, for women in resource-poor or hard-to-reach settings, by improving availability, accessibility, acceptability and quality of services. PRESCRIP-TEC focuses on implementation research into secondary prevention of cervical cancer in different settings in four countries over three continents: Bangladesh and India in Asia, Uganda in Africa, and Slovakia in Eastern Europe. The project builds on interventions with promising or proven effectiveness including cost-effectiveness: - hrHPV based screening is cost-effective when adequate coverage is reached. - Self-swab for hrHPV leads to higher uptake of screening compared to sampling by clinicians. - Visual inspection with acetic acid (VIA) is an approved screening method by the WHO and is part of the national cervical cancer prevention programme in Uganda, Bangladesh, India; in India AI to support VIA screening was shown to be effective in detecting VIA positive lesions. The dataset concerns the following research question per target country: Which are the client-related factors for accessibility and acceptability and adherence to the enhanced screening protocol?

Eligible women for the study were women who were 1) living in the study areas and based on their age eligible for cervical cancer screening according to national guidelines, 2) not pregnant, 3) not screened in the previous period whether it was defined based on the national screening policy, and 4) having the cognitive abilities to understand and answer to the questions and give informed consent. Convenience and random sampling were used for selection of respondents and different steps for recruitment were undertaken in each country. In Uganda convenience sampling was applied and eligible women were invited for participation. In Bangladesh sampling at household level was done. Households in the study areas were included for participation if females, husbands and mothers in law from wanted to participate. First convenience sampling was applied and thereafter random sampling was followed. In India, consecutive sampling was applied to approach eligible women and decision makers across various centerscentres. Decision makers were interviewed from the same household when they were considered by the women as being a decision maker. Male decision makers were either husband, son, father or father-in-law and female decision makers were mother or mother-in-law. In Slovak Republic the snowball sampling method was applied to approach eligible women from marginalised Roma communities. Partners or relatives of participating women were approached for participation as well.

The African Women Awareness of Cancer (AWACAN) questionnaire for measuring women’s awareness of breast and cervical cancer (Moodley, 2020) was adapted for use within this study. The PRESCRIP-TEC research team selected the questions solely addressing cervical cancer awareness from the AWACAN survey and developed a AWACAN survey suitable for decision-makers by modifying the selected AWACAN questions. For female respondents, the AWACAN instrument included five socio-demographic questions and five questions on the history concerning cervical cancer screening and treatment and one question on household decision-making. For both females and household-decision makers the adapted survey questionnaire included a total of 53 questions. The tool measures cervical cancer awareness in the following domains: risk factors, symptoms, lay beliefs, confidence in appraisal, help-seeking behaviours, and barriers to health care. The questionnaire is a mix of open, closed and multiple-choice questions. Questions about risk factors are only asked to respondents if they indicate to have heard about cervical cancer. Knowledge scores of risk factors and symptoms were are calculated by assigning 1 point to each "Yes" response and a 0 to "No" response. The cumulative score for knowledge of correct risk factors ranges from 0 to 11 and the cumulative score for knowledge of all symptoms ranges from 0 to 12. The AWACAN tool has shown to be reliable and valid for use in Sub-Saharan Africa (Moodley, 2019) and to our knowledge the instrument has not been used previously in Bangladesh, India and Slovak Republic.

The AWACAN survey was conducted in four countries, in Bangladesh, India, Uganda and Slovak Republic in the context of the PRESCRIP-TEC project.