Strengthening the Role of Cadres and Village Midwives to Support the Cervical Cancer Awareness Movement in Puhu Payangan Village, Gianyar, Bali, Indonesia

Desak Putu Oki Lestari(1*), Sri Ratna Dewi(2), Ni Wayan Armerinayanti(3)

(1) Department of Anatomical Pathology, Medical Education Study Program, Faculty of Medicine and Health Education, Universitas Warmadewa
(2) Department of Clinical Pathology, Medical Education Study Program, Faculty of Medicine and Health Education, Universitas Warmadewa
(3) Department of Anatomical Pathology, Medical Education Study Program, Faculty of Medicine and Health Education, Universitas Warmadewa
(*) Corresponding Author


Cervical cancer is the most common type of cancer in Balinese women, and most of the cervical cancer patients came in advanced condition. The health survey conducted in the village of Puhu, Payangan, Gianyar, found that the coverage of cervical cancer screening is 12%, which is considered as low. Payangan’s sub-district health centers (Puskesmas) have made an effort to give free PAP smear screenings to the local community, but it still has not received a good response. This is related to the community’s lack of knowledge on cervical cancer, low awareness of cancer screening, and false stigma about PAP smear examination. To overcome this problem, an effort is needed to increase awareness about the need for PAP smear screening by shaping it into a cervix cancer awareness movement "Gardavi", involving village midwives and housewife members of Empowerment and Family Welfare Group (PKK) in Puhu Village as cadres. Methods that are used in this community service include training for midwives, activation of tiered information system involving midwives-cadres and the community, knowledge provision as well as motivating cadres. This event is done to increase the role of village midwives and cadres to actively participate in PAP smear screenings in their region, therefore, it may increase screening outcomes and lower mother morbidity and mortality numbers due to cervical cancer. This event results in increased midwives’ knowledge and skill on the technique of sampling PAP smear independently, increased visits to the Community Health Sub-Center (Pustu) for PAP smear examination, creation of a midwives-cadres-community coordination system, cadres independently playing an active role in motivating the village community to do screening, as well as increased cadres’ optimism.


Cervical Cancer; PAP Smear Screening; Midwives; Health Cadres Indonesia

Full Text:



Akinlotan, M., Bolin, J. N., Helduser, J., Ojinnaka, C., Lichorad, A., & McClellan, D. (2017). Cervical Cancer Screening Barriers and Risk Factor Knowledge Among Uninsured Women. Journal of community health, 42(4), 770–778. DOI:

Anfinan, N., & Sait, K. (2020). Indicators of survival and prognostic factors in women treated for cervical cancer at a tertiary care center in Saudi Arabia. Annals of Saudi medicine, 40(1), 25–35.

Arani, M. (2019). Keikut sertaan Wanita Pasangan Usia Subur (PUS) Dalam Melakukan Deteksi Dini Kanker Serviks Dengan Metode IVA (Inspeksi Visual Asam Asetat) Di Wilayah Kerja Puskesmas Simpang. Journal of Midwivery Science, 3(1), 22-24.

Catarino, R., Petignat, P., Dongui, G., & Vassilakos, P. (2015). Cervical cancer screening in developing countries at a crossroad: Emerging technologies and policy choices. World journal of clinical oncology, 6(6), 281–290. DOI:

Domingo, E. J., Noviani, R., Noor, M. R., Ngelangel, C. A., Limpaphayom, K. K., Thuan, T. V., Louie, K. S., & Quinn, M. A. (2008). Epidemiology and prevention of cervical cancer in Indonesia, Malaysia, the Philippines, Thailand and Vietnam. Vaccine, 26 Suppl 12, M71–M79. DOI:

Indonesia, D. J. (2011). Kanker di Bali Tahun 2011. In Kanker di Indonesia Tahun 2011. Jakarta.

Medik, D. J. (2011). Kanker di Bali Tahun 2011. Jakarta.

RI, K. K. (2015, April). Program Nasional Gerakan Pencegahan Dan deteksi Dini Kanker Leher Rahim Dan Kanker Payudara. Jakarta, DKI Jakarta, Indonesia.

Stoler, M. (2014). Squamous Cell Tumours and Precursors. In J. R. Kurman, M. L. Carcangiu, C. S. Herrington, R. H. Young, & Lyon, WHO Classification of Tumours of Female Reproductive Organs (pp. 170-182). Lyon: WHO.

Widarsa, T. (2017). Survei Kesehatan Desa Payangan Gianyar Sebagai Desa Binaan Fakultas Kedokteran Universitas Warmadewa. Denpasar.


Article Metrics

Abstract views : 896 | views : 995


  • There are currently no refbacks.

Copyright (c) 2021 Jurnal Pengabdian kepada Masyarakat (Indonesian Journal of Community Engagement)

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Jurnal Pengabdian kepada Masyarakat (Indonesian Journal of Community Engagement)

ISSN (print) 2460-9447ISSN (online) 2541-5883