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Availability and Uptake of Cervical Cancer Screening and Treatment Services at 19 Kenyan Health Facilities: A Brief
Catherine Wexler1, May Maloba2, Natabhona Mabachi3
1Department of Family Medicine and Community Health, University of Kansas Medical Center, Kansas City, KS.
Purpose:
In 2012, Kenya announced its commitment to prioritizing cervical cancer (CC) services with the National Cervical Cancer Prevention Program. However, gaps in implementation remain, causing suboptimal uptake. The goal of this study is to provide a situational analysis of 19 government health facilities in Kenya to assess facilities' capacity to provide CC screening and treatment.
Methods:
We conducted a retrospective data review at 19 health facilities in Siaya and Busia counties of Kenya from September 2021 to September 2022 to assess availability and uptake of CC services. Key variables included hospital volume, positivity, and numbers of women screened, treated, and referred. Notes were taken to document challenges with service provision and data collection. The retrospective review informed site matching for a proposed cluster-randomized trial.
Results:
There were a total of 16,757 CC screenings or rescreenings documented across the 19 study sites during the study period. Across the 19 facilities, 10.8% of the women enrolled in care at the hospital were screened during the data collection period. The overall positivity was 3.8% but ranged from 0.7% to 16.7%. Of the 19 facilities offering CC screening, five lacked the required equipment to provide same-day treatment, and complex referral pathways were noted for women needing to seek care elsewhere. Challenges with documentation were noted at all stages of CC services.
Conclusion:
Gaps noted were low screening rates, opportunities to improve the efficiency of CC services, structural limitations in implementing the screen-and-treat approach, and poor documentation of CC services and outcomes. Urgent action is needed to ensure that all facilities offering CC screening are equipped with the personnel, supplies, and equipment necessary to conduct guideline-adherent same-day cryotherapy or thermal ablation treatment and improve documentation at the facility level to track CC services across the cascade of care.
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