Are the screening and definitive diagnosis procedures and the appropriate interventions acceptable to the population in need of the services.

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Screening or diagnostic procedures or treatments that are inconvenient, uncomfortable, or invasive , violate cultural taboos, or result in social stigmatization or economic hardship are likely to be insufficiently used by the public. The best way to avoid introducing unacceptable services is to involve menders of the community in decisions about which services, if any , to introduce, and how . the preferences and convenience of the population to be screened and treated on the basis of screening results are frequently not considered, with predictable consequences. For example, workers need preventive services they can receive without loss of pay. Maternal and child health services, including family planning, need to be organized so as to take account of problems of child care, transport, and the responsibilities of working mothers . the maximum integration of screening activities into established, locally available services used by the population will tend to minimize inconvenience.
Attention to cultural preferences is essential. For example , it may be important for gynaecological and obstetric services to be provided by women only; in some cultures, all services to women need to be provided by women . blood –testing may not be acceptable in some societies. Health workers involved in early detection activities need to be trained to encourage the use of services by explaining the process to patients, by providing the services in courteous and considerate manner , and by respecting patients privacy. Intensive retraining and periodic refresher courses may be necessary to foster the appropriate attitude towards patients. In small communities where workers and patients know each other well, special training and appropriate systems of documentation and handling information should be developed to ensure the confidentiality of potentially sensitive data; periodic retraining is essential.

Even services that are acceptable may not be used id they are not be used if they are not valued by the population. Public education may be necessary, with special outreach to groups at particularly high risk. Community involvement in the design, implementation, and evaluation of services can help ensure that they are acceptable to , valued, and hence used by those in need. 

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