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Cervical Cancer Prevention in East Africa: Moving from Evidence to Implementation

  • Megan J. HuchkoEmail author
Chapter

Abstract

Cervical cancer is a highly preventable disease that exposes the marked disparities in women’s health around the world. Despite a highly effective vaccine and screening technologies, over 500,000 women are diagnosed with the disease every year, with about 9 out of 10 cervical cancer cases and deaths in low-resource countries. One such country is Kenya, which has a low cervical cancer screening rate and a high incidence rate. In order to implement an evidence-based cervical cancer prevention program, we carried out focus group discussions with key stakeholders in rural western Kenya to evaluate barriers and facilitators to screening. Participants identified education around HPV, cervical cancer, and screening as very low in the community as main barriers to screening. Community members reported fear of pain and embarrassment as significant barriers to a screening pelvic exam. They also reported that providers’ lack of knowledge and discomfort with a sensitive subject were significant barriers. A personal connection to cervical cancer and/or screening was associated with willingness to screen and awareness. Providers reported workload and lack of supplies and trained staff as significant barriers to offering services. To be effective, cervical cancer programs must take into account the local realities in which they occur. This study took a systematic, theory-driven approach to identifying intervention strategies based on focus groups and interviews with community members and healthcare providers, and used the results to further contextualize an evidence-based implementation strategy.

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Suggested Reading

  1. Denny, L. A., Sankaranarayanan, R., De Vuyst, H., Kim, J. J., Adefuye, P. O., Alemany, L., & Bosch, F. X. (2013). Recommendations for cervical cancer prevention in sub-saharan Africa. Vaccine, 31 (Suppl 5), F73–74. doi: 10.1016/j.vaccine.2012.11.077.
  2. Ogilvie, G. S., Mitchell, S., Sekikubo, M., Biryabarema, C., Byamugisha, J., Jeronimo, J., & Money, D. M. (2013). Results of a community-based cervical cancer screening pilot project using human papillomavirus self-sampling in Kampala, Uganda. International Journal of Gynaecology and Obstetrics, 122(2), 118–123. doi: 10.1016/j.ijgo.2013.03.019.
  3. Tsu, V., & Jeronimo, J. (2016). Saving the world’s women from cervical cancer. The New England Journal of Medicine, 374(26), 2509–2511. doi: 10.1056/NEJMp1604113.

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Obstetrics & Gynecology and the Duke Global Health InstituteDuke UniversityDurhamUSA

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