How CHAI and Unitaid are helping countries like Nigeria build a future free of cervical cancer
- To mark the World Health Organization’s second anniversary of Cervical Cancer Elimination Day of Action today, CHAI looks at the impact of its cervical cancer program
Cervical cancer is preventable when identified and treated at the pre-cancer stage. Yet, this preventable disease still kills 300,000 women each year, with more than 90 percent of deaths occurring in low and middle-income countries. With support from Unitaid, CHAI is working with governments across sub-Saharan Africa and India, to expand access to high-quality and affordable screening and treatment tools, deliver effective models that best reach the women in target communities, and address key barriers to women’s health.
CHAI is currently working with Ministries of Health in India, Kenya, Malawi, Nigeria, Rwanda, Senegal, South Africa, Uganda, Zambia, and Zimbabwe. As of June 2022, CHAI’s program has screened more than 725,000 women and successfully treated more than 80 percent of women who tested positive in the countries we’re working with.
In Nigeria, investments to eliminate cervical cancer as a public health issue are already paying off. The Unitaid-funded program, implemented by CHAI in collaboration with the Federal Ministry of Health and States Ministries of Health in Lagos, Kaduna, and Rivers, has already exceeded the WHO global target of treating 90 percent of women who screened positive in Nigeria.
Over the past two years:
- 1,200 healthcare workers have been trained across 177 public health facilities to deliver high-quality cervical cancer secondary prevention across the three program states.
- More than 200,000 women have been screened for cervical cancer and 4,780 women have been treated for precancerous lesions using cost-effective treatment devices, which represents a 97 percent treatment completion rate.
- Sustainable service structures, information management systems, and screen and treat protocols have also been successfully built.
Educating and upskilling health workers
A key element of the program is providing high-quality training to health workers. Chindo Mercy Nsisanobari is the matron in-charge of Ogale Primary Health Care Centre at the Eleme Local Government Area in Rivers State, Nigeria. In September 2020, she participated in training on cervical cancer secondary prevention organized by CHAI in collaboration with the State and Federal Ministry of Health.
“This training gave me the tools and knowledge to identify cervical changes through screening and treat precancerous lesions using a thermal ablation device. As soon as I returned to my health facility, I started including cervical cancer messaging in my routine health talks and some of my patients showed interest in being tested.”
Over the first three months, Chindo screened up to 15 women with one of them testing positive. Chindo referred her patient to the University of Port Harcourt Teaching Hospital for treatment as at the time she didn’t feel confident enough to perform the treatment procedure for fear of burning her patient’s vagina walls. A few weeks later, CHAI introduced the peer mentoring program at Chindo’s health facility to strengthen her treatment skills. During this program, five patients were tested positive, and all were successfully treated.
“The procedure seemed so easy, and the patients did not feel great levels of pain as I was anticipating. I have now stopped referring my patients to other hospitals, I treat them both within and outside the facility effortlessly.”
Improving access to lifesaving services
“I thank God for the doctor who tested me,” said Talatu John, a farmer and mother of three living in Kachia in Kaduna State. “When they told me that I had abun da ke janyo ciwon daji (precancerous lesions), I thought I would eventually die soon but they informed me that I could be treated.”
Talatu was screened for cervical cancer and tested positive for precancerous lesions during a rare visit to General Hospital of Kachia as she was experiencing a recurrent gynecological issue. She was then referred to the General Hospital of Kafachan for treatment with a thermal ablation device. Talatu relies heavily on traditional medicine for most of her ailments, and when necessary, buys additional medications from her local chemist. Like many women in her community, she rarely goes to the hospital for treatment and care, and therefore misses out on critical health information that can be beneficial for her health. In addition, in Nigeria, there are some upfront charges that patients need to pay to access care, which constitutes another deterrent to going to the hospital.
Through Unitaid support, CHAI has worked with suppliers in Nigeria and our other partner countries, to secure price agreements to make thermal ablation devices more affordable and accessible in low- and middle-income countries, and supports governments in rolling out the devices in national screening programs. Access to cervical cancer screening and treatment services is, therefore, free for patients.
“I was happy to find out that the treatment was free. Now I know about abun da ke janyo ciwon daji (precancerous lesions) and I know this killer disease can be prevented if detected early.”
Over the past two years, the program being delivered in all the partner countries has proven to provide affordable and effective tools and is significantly helping partner countries on the path to elimination. Looking to the future, however, additional investments are critical to continuing the acceleration and scale-up of access to these lifesaving services in partner and additional countries.