Community health campaigns reach more women for cervical cancer screening in Kenya

Cervical cancer is highly preventable, yet more than 500,000 women are diagnosed every year. Ninety percent of cases are in low-resource countries that lack money, personnel and infrastructure to implement programs that have worked to reduce mortality in wealthier countries. A study from Bixby Center researchers and colleagues in Kenya points to a potentially high-impact and cost-effective way to screen women for HPV and prevent cervical cancer.

The research team compared delivering HPV screening with self-collected samples through community health campaigns (CHCs) and government health clinics. The community health campaigns consisted of two weeks of targeted mobilization and outreach, two weeks of screening in tents set up in villages and two weeks of notifying women of results and community feedback. Health clinics saw patients throughout the same timeframe.

While using self-collection increased screening rates in general, the CHCs were more effective in getting women into screening. Sixty percent of eligible women in the CHC communities were tested, versus 37% at clinics. Women found self-collection of vaginal samples to be straightforward and comfortable, and almost all of them would recommend it to a friend. By only linking women who screen positive to health facilities, they reduced the burden on clinics and patients. However, treatment rates were low in both arms of the study. The next phase will explore approaches to linking more women with treatment.

Researchers also looked at which model was most efficient for patients and providers. Wait time can be a major barrier to women accessing care, and efficiency is key in delivering care to many people with limited resources. HPV screening visits at CHCs saved patients about 45 minutes, even though active time with a patient was longer at CHCs than at clinics. Some patients at clinics may have received other health services, meaning clinics could potentially reduce wait time by integrating HPV screening with other maternal services. Increasing the provider to patient ratio could also help improve flow and efficiency.

The success of the CHC model of reaching women who need screening and saving them time out of their busy lives can serve as a starting point to refine the approach and maximize its impact. Building on this success could help improve the availability of health care and dramatically reduce the burden of cervical cancer for vulnerable women worldwide.

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