How to integrate screening for cervical cancer into grassroots health services for low income countries: An implementation research

ABSTRACT

This implementation research examines the feasibility of training health care workers at grassroot level in Vietnam to perform visual inspection with acetic acid as a regular screening service for cervical cancer at commune health stations (CHSs). Employing a two-phase design, the study trained 36 nurses working at CHSs to do VIA screening method in the first phase. In the second phase, evaluation on the capacity of those trained to do VIA method as well as client’s satisfaction with VIA services performed in CHSs setting was done among 380 clients. Results indicated that within a short time, CHS nurses can be trained to perform VIA correctly (80.6% felt confident to perform VIA and 75% was able to perform test efficiently). All clients showed high level of satisfaction with VIA services provided at CHS setting. This implementation research provided evidences that VIA screening services performed by local midwives/nurses at grassroots level can be an optimal solution to deal with both the raising burden of cervical cancer and the current concern of shortage of well-trained doctors in low resource setting areas. It also gave some important lessons for health care managers on how to sufficiently integrate cervical cancer screening in low resource settings.

KEYWORDS:

• Visual inspection
• acetic acid
• screening
• cervical cancer
• implementation research
• Vietnam
• primary healthcare

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Ngan T. K. Nguyen

Ngan T. K. Nguyen, Linh T. Nguyen and Hoang T. Le had training background as Master of Public health. Currently, they are lecturers at the Department of Epidemiology and Biostatistics, Hanoi University of Public Health.

Linh T. Nguyen

Ngan T. K. Nguyen, Linh T. Nguyen and Hoang T. Le had training background as Master of Public health. Currently, they are lecturers at the Department of Epidemiology and Biostatistics, Hanoi University of Public Health.

Hoang T. Le

Ngan T. K. Nguyen, Linh T. Nguyen and Hoang T. Le had training background as Master of Public health. Currently, they are lecturers at the Department of Epidemiology and Biostatistics, Hanoi University of Public Health.

Binh T. Nguyen

Dr. Binh T. Nguyen had training background as MD and PhD in Public Health. Currently, she worked at Food Safety management authority of Bac Ninh province, Bac Ninh, Vietnam.

Nha Ba Pham

Professor Nha Ba Pham had training background as MD and PhD in Medicine. Currently, he chairs the Department of Obstetrics and Gynecology, Bach Mai Hospital, Hanoi, Vietnam.

Phuong Lan Pham

Dr. Phuong Lan Pham had training background as PhD in Public Health. Currently, she is Head of Training Department, National Hospital for Obstetrics and Gynecology.

Lan T. H. Vu

Professor Lan T. H. Vu had training background as MD and PhD in Epidemiology. Currently, she is head of the Department of Epidemiology and Biostatistics as well as Chair of the Faculty of Fundamental Sciences, Hanoi University of Public Health.