By: Alexandra Steverson, Program Assistant for the Southern Africa Region*
Globally, one woman dies every two minutes from cervical cancer. As the second most common cancer among women, there are 530,000 new cases every year. The developing world is disproportionately burdened by this disease – 86% of cases occur in developing countries where prevention services are limited or unavailable. In some environments, the mortality rate is as high as 52%.
We know that infection with one of many strains of the Human Papillomavirus (HPV) is a leading cause of cervical cancer. The good news is that it can be prevented. Screening and treatment of pre-cancerous lesions is the most cost effective method of preventing the disease and creating positive health impact in low-resource settings. However, less than 5% of women in developing countries have accessed screening services. With simple, low-cost interventions, organization like PSI can improve health outcomes for a population that is often neglected, women around the world.
Unreliable health system infrastructure and public sector screening, treatment, and referral networks are barriers to cervical cancer prevention. PSI’s social franchise networks address these problems by increasing a woman’s access to quality, affordable life-saving services. PSI currently offers cervical cancer screening services through our franchise clinics, and other public sector support models, in eight country programs. Four more country programs are in the process of integrating cervical cancer services into their existing family planning services. Franchise clinics provide the opportunity to integrate cervical cancer screening with already established reproductive health programs.
In many communities health seeking behaviors are oriented to disease treatment as opposed to timely prevention, fostering a lack of awareness of the importance of early screening and treatment. Many women wait to seek care until HPV infection has manifested as cancerous lesions on the cervix or worse, invasive cancer that has spread to other parts of the body. By using behavior change communications and social marketing, PSI is able to bolster demand for and education surrounding cervical cancer screening and prevention on a local level.
Zimbabwe faces many of these barriers as PSI prepares to initiate cervical cancer programming there for the first time. The government has begun to provide cervical cancer screening and treatment using VIA ( visual inspection with acetic acid) and cryotherapy at few selected hospitals mainly located at central level. Yet most women live in rural areas with limited access to public services and awareness about cervical cancer and screening services is very low. Few women actively seek prevention services, a behavior that cuts across social class. With help from the British Government’s Department for International Development (DfID), PSI/Zimbabwe is expanding access to VIA cervical cancer screening services through their New Start franchise clinics currently offering HIV testing and counseling and family planning services. PSI/Zimbabwe will provide integrated care and advocate within local communities and at the national level to increase the perceived value for prevention services among women.
In Kenya, cervical cancer is the leading cause of cancer related deaths in women. It is estimated that less than 3.2% of women aged 18-69 have ever been screened for cervical cancer. PSI/Kenya, through the Tunza Family Health Network, is supporting cervical cancer screening using visual inspection with acetic acid (VIA) since 2010. VIA is a simple technique ideal for low-resource settings involving the application of dilute acetic acid, or vinegar, to the cervix and observing for a change in tissue color as cancerous cells will turn temporarily white.
Using a team of quality assurance officers, over 213 Tunza providers have been trained in VIA and integration of screening with reproductive health services. PSI/Kenya has successfully leveraged their extensive network of 295 clinics to improve access to quality services and proper referral networks for low-income communities and women most at risk. The Tunza franchise has screened over 54,000 women. Of these, over 775 tested positive for HPV and over 500 women had suspicious lesions. From these screening tests, providers in the Tunza network were able to refer over 1,200 women for follow-up care in other facilities. PSI/Kenya is utilizing their franchise network to provide much needed prevention services in communities where women may not otherwise have received care.
PSI is committed to increasing access to cervical cancer screening and treatment services. Healthy women lead to healthy families and communities. Cervical cancer prevention is one way we can help improve women’s health, provide integrated care, and offer cost-effective, scalable interventions.
We look forward to the increasing success of our programs and encourage you to remember the importance of screening during Cervical Cancer Awareness Month and on February 4, World Cancer Day.
Click here to learn how you can help PSI end cervical cancer.
*With support from:
Titus Mungou, Corporate Communications Manager from PSI/Kenya
Joyce Wanderi Maina Director, Social Marketing from PSI/Kenya
Dr.Preston Izulla, Quality Assurance Manager from PSI/Kenya
Patience Kunaka, Interpersonal Communications Manager from PSI/Zimbabwe
Nyaradzo Muhonde, Clinical Manager from PSI/Zimbabwe