Routine monitoring information successfully contributes to scaling up the Mozambican national cervical cancer prevention program

The Mozambique cervical cancer prevention (CECAP) program was initiated in 2010 in seventeen facilities. The primary approach for CECAP is visual inspection of the cervix using acetic acid (VIA) and same-day treatment of precancerous lesions with cryotherapy. This approach is desirable because it provides a potentially life-saving service with just one visit; it is commonly referred to as the Single Visit Approach, or SVA. CECAP is integrated into the general sexual and reproductive Health (SRH) service package; women are offered VIA and cryotherapy, as well as breast cancer screening, when they seek family planning services. When the national health information system (NHIS) was recently updated, the MOH reviewed patient forms, registers and reporting procedures to ensure that the routine information system provided data on integrated SRH and cancer prevention services. Data from the NHIS from the initial 17 facilities shows that 15,080 women were screened using VIA and 15,309 were screened for breast cancer in 2010 and 2011. Seven percent of those screened for cervical cancer were VIA positive. Of all eligible VIA positive clients, 80% were treated with cryotherapy on the same day. Additionally, 909 clients were referred either for large lesions not treatable with cryotherapy, suspect cancer or other gynecological reasons. Monitoring routine information demonstrated the feasibility of integrating CECAP into SRH services. It also demonstrated the need for CECAP (7% VIA positivity rate). Based on this information, the MOH plans to expand CECAP from the current 96 facilities covering all provinces by 2014.