HPV-based cervical cancer screening in low-resource settings: Maximizing the efficiency of community-based strategies in rural Kenya.

Journal Article

OBJECTIVE: To characterize the efficiency of screening through high-volume community health campaigns (CHCs) by comparing the costs and population reach and identify factors associated with gains in efficiency. Access to effective cervical cancer screening remains limited in low-resource settings, especially in rural areas. Periodic CHCs are a novel method of offering screening for HPV at lower costs and higher population coverage than health facilities. METHODS: A micro-costing study was conducted within a cervical cancer screening trial to measure efficiency (cost per woman screened) and population uptake of HPV-based screening offered through CHCs in Migori County, Kenya between January and September 2016. Regression analysis assessed relationships between population size and efficiency. Structured observations and qualitative interviews identified implementation factors that affected efficiency in individual campaigns. RESULTS: Communities screening through CHCs had costs per woman screened ranging from US $22.06 to $30.21. Efficiency was directly correlated to overall numbers of women screened, but not to proportion of population screened. Modifiable factors that acted as context-specific facilitators and barriers with a potential impact on efficiency were identified. CONCLUSION: There was substantial variation in efficiency among CHCs. Cultural factors, health beliefs, and poor coordination among implementation partners as potential key barriers to screening uptake were identified.

Full Text

Duke Authors

Cited Authors

  • Huchko, MJ; Olwanda, E; Choi, Y; Kahn, JG

Published Date

  • March 2020

Published In

Volume / Issue

  • 148 / 3

Start / End Page

  • 386 - 391

PubMed ID

  • 31849036

Pubmed Central ID

  • 31849036

Electronic International Standard Serial Number (EISSN)

  • 1879-3479

Digital Object Identifier (DOI)

  • 10.1002/ijgo.13090


  • eng

Conference Location

  • United States