Cervical Cancer Prevention

One cost-effective approach to preventing cervical cancer combines visual inspection of the cervix, using ordinary table vinegar, and same-day cryotherapy. Here, health personnel learn how to freeze premalignant cancer cells.

In Ethiopia, women access life-saving services through Pathfinder’s first and largest cervical cancer prevention project.

This five-year award from the Centers for Disease Control enables Pathfinder to increase access to and use of cervical cancer prevention services among HIV-positive women in Ethiopia. This initiative leads to improved care for a very treatable condition, cervical pre-cancer, if diagnosed early. Working with the Ministry of Health, Pathfinder is building national capacity to support comprehensive facility-based services; promoting community education and awareness of cervical cancer; and establishing strategic alliances and partnerships to expand the use of these services. Stanford University’s Program for International Reproductive Education and Services, the project’s international technical partner, provides technical knowledge, evidence-based training materials, and extensive experience with cryotherapy in low-resource settings.

Now in its fourth year, the project has established services at all 14 planned facilities, including five Centers of Excellence plus nine other facilities, all of which are providing single-visit approach to cervical cancer prevention services. So far, the project has provided visual inspection with acetic acid services to almost 12,000 women, which well exceeds the life-of-project target of 5,000. In fact, most of the hospitals that initiated services early in the project have nearly exhausted targeted clients in their catchment areas, and there is great interest in expanding services to the general population who are in need of services.

Of significant importance is the introduction of Loop Electrosurgical Excision Procedure (LEEP), which was not a part of the original project design. LEEP has heretofore been unavailable for women with large cervical lesions whose only alternative was hysterectomy. LEEP is valuable not only to the client, but also represents significant cost savings for the Ethiopian health care system. We procured several LEEP machines and introduced this service with targeted and intensive training. A second LEEP workshop in November 2012 provided an opportunity to test and improve our recently-developed LEEP training materials for use in resource-poor settings.