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

IntroductionCervical 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 analysisResearch 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 DisseminationThis 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.