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Program organization rather than choice of test determines success of cervical cancer screening: Case studies from Bangladesh and India
Author(s) -
Bhatla Neerja,
Nessa Ashrafun,
Oswal Kunal,
Vashist Shachi,
Sebastian Paul,
Basu Partha
Publication year - 2021
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13486
Subject(s) - cervical cancer , test (biology) , business , health care , public health , developing country , medicine , computer science , risk analysis (engineering) , operations management , economic growth , cancer , engineering , nursing , economics , paleontology , biology
The call for elimination of cervical cancer as a public health problem by the World Health Organization has led to intense focus on the burden of disease, available resources, and the possibility of introducing efficient systems for screening and treatment that allow effective cancer control in limited‐resource settings. Presently, the focus is on the introduction of rapid, technologically less‐demanding, affordable HPV testing. However, until such tests become widely available, the momentum that has been gained using visual inspection with acetic acid (VIA) should not be lost. Countries with limited resources and a heavy burden of cervical cancer, such as Bangladesh and India, introduced and scaled up VIA‐based programs with varying degrees of programmatic organization and performance. Despite its limitations, VIA’s simplicity and affordability has allowed these countries to build infrastructure, increase numbers of trained healthcare personnel, and develop a system of multilevel coordination within the health system. Such efforts will have long‐term advantages provided that countries have access to an appropriate HPV test and build on their efforts to improve program organization through a strengthened health system, translating lessons learned in program implementation, logistics, and compliance with the new paradigm.