Implementation of a cervical cancer prevention training initiative in rural Senegal

While increasing access to primary health care services that are responsive to the local context improves health low-and middle-income country (LMIC) adoption of evidence-based solutions to strengthen local primary health care services remains deficient. To address these gaps in workforce training and service delivery, community-based participatory approaches can be used to carry out health workforce strengthening by engaging providers and communities in service implementation processes. This project reports on a collaboration between the health region of Kedougou, Senegal, the Peace Corps and a university based (UIC) multidisciplinary health team. Since 2010 this partnership has implemented regional-level cervical cancer prevention clinical guidelines outlining a service accessible to an estimated 10,000 women in the target population (women 30-49 yo).  Using a train the trainers approach the evidence-based and cost-effective screen and treat technique of visual inspection of the cervix with acetic acid provided this skill set to 60 nurses and midwives and trained one physician in cryotherapy for pre-cancer treatment. Ongoing process and impact evaluations of this project point to common implementation barriers such as shifting health workforce priorities depending on more immediate and emergent needs such as seasonal illnesses, successes such as increased awareness/action regarding cervical cancer among women in the region and lessons learned such as the need to continue focus on improving accessibility and quality of services provided. Requests for replication of cervical cancer prevention services to other regions within Senegal as well as from other resource challenged countries using this model have been made and will be discussed.