Bondo, Kenya—With her bright blouse and matching earrings, Josephine Awour stands out from the dozens of patients waiting in line at the district hospital here. She has come in for a checkup. Josephine, who is HIV-positive and often visits the clinic, had never thought about cancer until she listened in on a health talk on cervical cancer screening and early treatment.
“I knew after listening to the talk that it was important for me to get screened,” says Josephine.
Josephine benefited from a Jhpiego-championed screening method known as visual inspection with acetic acid, the main component in vinegar. When the health care provider found pre-cancerous lesions on Josephine’s cervix, she was immediately referred for cryotherapy treatment, a freezing technique used in the innovative “single visit approach.” Under the single visit approach, clients receive cervical cancer screening and treatment (if needed) during the same visit. Josephine left the hospital that day relieved and thankful that a potentially life-threatening condition had been addressed promptly.
In Kenya, cervical cancer is the leading cause of cancer deaths in women of reproductive age, affecting about 2,500 women each year. In spite of the fact that cervical cancer is almost 100 percent curable if detected early, 68 percent of patients in Kenya die from the disease. Moreover, cervical cancer screening coverage in Kenya for all women is only 3.2 percent.
Jhpiego has been a leader in establishing and scaling up innovative, low-tech cervical cancer prevention programs, using the award-winning and cost-effective single visit approach. As part of its comprehensive work in preventing cervical cancer in Kenya, Jhpiego has:
- Supported revision of the National Cervical Cancer Prevention and Control Strategic Plan and the National Guidelines for Reproductive Tract Cancers
- Developed training resources and conducted competency-based training for health care providers and supervisors nationally and regionally
- Spearheaded integration of cervical cancer screening into other programs including outreach and advocacy campaigns
- Led the development of a basic package of cervical cancer prevention and treatment monitoring and evaluation tools
In Bondo sub-county, more than 60 health care providers have been trained on the single visit approach, which consists of swabbing the cervix with vinegar solution, visually inspecting the cervix to detect pre-cancerous lesions and offering cryotherapy treatment in the same visit if lesions are found. Additionally, these providers have been updated on the national strategy and country guidelines on cervical cancer prevention and management, patient counseling, community mobilization and the vaccine to protect against the human papillomavirus (HPV), a leading cause of cervical cancer.
Prisca Duro, the Nurse Services Manager at Bondo District Hospital, is one of six nurses at the hospital who were trained on the single visit approach. “Just two short years ago, we never screened our patients for cervical cancer. If we suspected a case, we had to send the patient over 65 kilometers away to the Kisumu District Hospital for screening and treatment,” Prisca says.
As a result, most cervical cancer cases were detected when it was too late for treatment. Today, over 70 percent of women who visit Bondo District Hospital are screened for cervical cancer.
Prisca is excited about the training that she and her staff have received from Jhpiego. “The skills we have received have made a major difference in the quality of care that we are giving our patients,” she says. “We have been taught more than screening; we have been coached and mentored on how to deliver compassionate, client-centered care.”