Bafoussam

This research aims to improve access to cervical cancer screening for women living in rural areas of the Mifi Health District in Cameroon. Cervical cancer causes a high number of deaths globally, especially in low- and middle-income countries due to low screening rates. The World Health Organization has set a goal for 70% of women to be screened, but this target is not met in Cameroon, particularly in rural communities. The study evaluates community co-produced action CCA strategies compared to traditional hospital-based screening approaches to increase screening coverage. The study uses a cluster-randomized design with 14 rural health areas divided into two groups. In the intervention group, participatory workshops with community members and a multidisciplinary team will co-develop local strategies for HPV-based cervical cancer screening, including awareness campaigns, collaboration with community health workers, health education materials, and access improvements. The control group will follow a standard hospital-based screening strategy coordinated by community health workers inviting women to screening at a regional hospital. All screened women will receive free HPV testing, triage, and treatment as needed. Participants will be women aged 30-49 years 25-49 if HIV-positive living in the specified rural areas. They will be invited to undergo screening, with follow-up assessments including triage for HPV-positive women and treatment when necessary. The study measures the number of women completing screening within 12 months, triage and treatment completion within 6 months, and follow-up visits at 12 months. The study monitors sociodemographic factors and evaluates the effectiveness of community-based strategies in improving screening rates over one year.

Cervical cancer is a major cause of death among women living with HIV, especially in resource-limited areas. This research compares two methods of cervical cancer screening a centralized approach using well-equipped centers, and a decentralized approach using a mobile team that brings equipment and staff to patient care locations. The study aims to find the most effective strategy for screening and treatment to inform national health decisions. The study involves a stepped-wedge design where all sites start with the centralized screening method. Over six periods of 10 weeks each, sites gradually switch to the decentralized mobile team strategy. In the centralized group, women provide a self-collected vaginal sample sent to a lab, and those testing positive travel to a reference center for further examination and treatment if needed. The mobile team visits health centers regularly to perform HPV testing and treatment on-site. Participants are women living with HIV, aged 25 to 49, eligible for cervical cancer screening and receiving or starting antiretroviral therapy. They will be followed to assess screening completion within 120 days after enrollment. The study includes questionnaires and evaluations on the acceptability, feasibility, and quality of each screening approach. Additional measures include the performance of urine HPV tests, methods to identify women needing treatment, and monitoring cervical health 12 months after treatment.