Project Lead(s): Pamela Njuguna
In Kenya, only 3.2% of women are screened for cervical cancer, which causes 1,700 deaths per year.
Conventional Cervical Cancer Screening (CCS) approaches are not always socially acceptable or readily accessible in low-resource settings, since they require intervention by medical personnel.
The project tested a cervical self-screening device, iPap, that is being developed by a U.S,-based company. While still in its prototype stage, iPap is a technically innovative cervical screening device that is affordable and meets social/financial requirements for low-income settings.
The project, called Chaguo Letu, used participatory action research methodology with the Scenario-Based Planning (SBP) method, along with analytic tools and techniques, to decide how to implement a Cervical Self-Sampling Program (CSSP) in both urban and rural settings in Kenya.
The key study design components for this research study included the application of the Participatory Action Research (PAR) methodology, SBP method and the Data to Decision Model to conduct an impact analysis and support informed decision-making when making choices on the implementation options for CCS.
The research efforts resulted in the development and application of a comprehensive decision-making framework that enabled informed decisions on how to implement CCS in Kenya.
The team found that the six variables of technical viability, political support, affordability, logistical feasibility, social acceptability and transformative innovation were all needed to support successful implementation of a sustainable CSSP.
The 107 women who participated in the project increased their knowledge about: the cause and symptoms of cervical cancer, the benefits of self-sampling to collect a cervical sample, and the importance of getting routinely screened for cervical cancer to prevent disease.
Overall, 97% of rural women and 100% of urban women reported their willingness to collect their own cervical sample.
A total of 44 consultations were conducted over the course of the project, involving project management team members, local decision influencers (i.e., government, academic, business and clinical representatives), subject matter experts and village women.
The level of diverse stakeholder participation was felt to contribute to the quality of the project deliverables, i.e., the comprehensiveness and relevance of the strategic directions and supporting implementation strategies.
The project team was able to demonstrate “how” a structured multimethod approach (using the PAR methodology, SBP method and Data to Decision model) was applied to make strategic, consequential choices on how a CSSP plan should be implemented in both urban and rural settings in Kenya.
Financial support for scaling is being sought from a global pharmaceutical company and a global technology vendor with a research centre in Nairobi, along with support from the iPap developer, the University of Nairobi, the government of Kenya and a private diagnostic laboratory in Kenya.
Work from the project has been presented and disseminated in conferences.