UICC World Cancer Congress 2006

Objective: India does not have any population based cervical screening program, despite having largest number of cervical cancer deaths. In 1999 we introduced cervical screening among beneficiaries who are the indigent slum-dwellers. The current paper discusses how we improved compliance by integrating screening with primary health support.

Methods: We enumerated women aged 30 to 60 years and invited them for group counseling. The women were screened by VIA test. We arranged free screening clinics within the slum areas. The compliance was less than 50% initially. We analyzed the feedbacks received from community health-workers, community leaders and women from the area. We realized that the women lacked preventive health orientation and were reluctant to consult physicians in absence of any symptoms. Their expectations from an interaction with any health facility were treatment for their common ailments and free medicines. The slum dwellers suffer from various diseases due to unhygienic environment and malnourishment. Realizing that primary health care facilities will be more acceptable we started primary health clinics in the area on regular basis and also supplied free medicines. Women attending such clinics either for themselves or for their family members were counseled for cervical screening. At that time they were more receptive and volunteered for screening at higher numbers. They felt that their visits to the clinics were worthwhile. This also improved credibility of our organization in the area, which improved the women's compliance to screening.

Results: Compliance to Cervical screening will improve if integrated with primary health service in resource-poor countries