Introduction Recognition of the burden of cervical cancer globally and the inequity of resources across low-, middle-, and high-income countries prompted the development of resource-stratified clinical practice guidelines from diagnosis to palliative care.

Methods A mixed-methods survey was developed addressing five major survey domains including diagnostics, surgery, radiation, treatment, and palliative care. The IRB-approved survey was disseminated to practicing members of oncology treatment teams in low-and middle-income countries and SPSS software was utilized for data analysis.

Results Of the survey respondents (n=52), 68% percent were from a low- or middle-income country. Only respondents from middle- and high-income countries indicated palliative care services were a part of their standard practice and palliative clinicians were included on multidisciplinary tumor board discussions. Of the barriers to palliative care services, significance (p < .05) by income strata was seen for service availability and pain/symptom management. Palliative care was ranked as having lowest importance for clinician education yet, was one of two survey domains rated with the highest frequency of challenges. Survey respondents identified the greatest site/team challenges as lack of qualified/trained staff (56%), lack of established protocols (50%), and limited/no access. Patient challenges to palliative care were identified by survey respondents as patient lack of knowledge (61%) and affordability of services (44%).

Conclusion/Implications The study identified challenges and barriers to palliative care self-reported by oncology team members practicing in low- and middle-income countries. Palliative care services and accessibility differed based on country income stratification which can inform future interventions to address system-based challenges.