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Evaluation of a 5‐year cervical cancer prevention project in I ndonesia: Opportunities, issues, and challenges
Author(s) -
Kim YoungMi,
Lambe Fransisca Maria,
Soetikno Djoko,
Wysong Megan,
Tergas Ana Isabel,
Rajbhandari Presha,
Ati Abigael,
Lu Enriquito
Publication year - 2013
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12052
Subject(s) - cryotherapy , medicine , cervical cancer , population , cervix , cancer , family medicine , gynecology , environmental health , surgery
Abstract Aim The C ervical and B reast C ancer P revention ( CECAP ) P roject sought to develop a national model for cervical cancer prevention in I ndonesia based on visual inspection with acetic acid ( VIA ) to detect abnormal changes in the cervix. The purpose of this study was to evaluate a pilot project introducing VIA and cryotherapy in I ndonesia and to identify lessons learned that could be applied to the national scale‐up of cervical cancer prevention services. Material and Methods Fifty‐four months ( J uly 2007 to D ecember 2011) of service records at 17 health centers were abstracted and analyzed. The data were used to calculate the proportion of all women aged 30–50 who received VIA screening, the VIA ‐positive rate, the treatment rate, and the interval between screening and treatment. Results The 45 050 women screened during the project included 24.4% of the total female population in the target age group in the catchment area. Throughout the 5‐year project, 83.1% of VIA ‐positive women sought cryotherapy. During the last 18 months of the project, after data collection tools were revised to more accurately reflect when cryotherapy was received, 13% of women were treated on the same day that they were screened. Among the 74% of women treated within 1 month of screening, the mean interval between screening and treatment was 7.2 days. Conclusion As cervical cancer prevention services are scaled up throughout I ndonesia, changes in the service delivery model and program management are needed to increase screening coverage, promote a single‐visit approach, and ensure the quality of services.