A Systematic Framework for Evaluating Cervical Cancer Screening Programs: Innovative Approaches and Best Practices.

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Cervical cancer remains a significant global health burden, disproportionately affecting low- and middle-income countries.
• Existing evaluation models for screening programs often lack comprehensiveness, neglecting essential elements like follow-up and treatment.
• Achieving the World Health Organization's 2030 elimination targets requires robust evaluation of current screening strategies.

Purpose of the Study:

• To propose a comprehensive framework for evaluating cervical cancer screening programs.
• To address identified gaps in existing evaluation methodologies by incorporating all critical program components.
• To provide a structured approach for assessing program performance and facilitating data-driven interventions.

Main Methods:

• A forward logic approach was utilized to map inputs, processes, outputs, and outcomes.
• The framework was developed through a review of national guidelines and definition of key performance indicators.
• Evaluation encompasses four core components: behavior change communication, screening, confirmation/diagnosis, and treatment.

Main Results:

• Key challenges identified include low screening coverage, inconsistent patient referrals, and high attrition rates throughout the screening cascade.
• The developed logic model offers a structured method for performance evaluation and data analysis.
• The framework facilitates timely interventions to improve program effectiveness.

Conclusions:

• Comprehensive evaluation frameworks are essential for enhancing cervical cancer control initiatives.
• The proposed framework supports efforts to meet the World Health Organization's 2030 cervical cancer elimination targets.
• Further validation of the framework across diverse settings is recommended to ensure its generalizability and effectiveness.