Collaborative Practice and Task shifting for Cervical Cancer early detection in Rural Districts of Tanzania

Introduction

Cervical Cancer is one of the common causes of death in women from low-resource settings. A cervical biopsy is a simple procedure to remove tissue from the Cervix to test for abnormal or precancerous conditions, or Cervical Cancer.

Despite Nurses have multiple roles in  the health facilities such as patient advocate, care provider and research investigators. They can also support in cervical cancer early detection and treatment.

In AGPAHI supported facilities, 180 Nurses were trained to provide Cervical Cancer screening using acetic acid and provision of treatment of aceto-white lesions using cryotherapy. In 2017, 12 nurses were trained to use punching forceps to collect cervical biopsy.

Methods

AGPAHI is supporting Cervical Cancer Prevention and treatment services in  six regions, by using single-visit approach (SVA) as the preferred service delivery model and Visual Inspection using acetic acid (VIA) and cryotherapy as the screening and treatment methods. These interventions are integrated in CTC and  reproductive health services in 57 supported health facilities.

Given the high demand for Cervical biopsy collection from women with suspicious cervical lesions, nurses from Sengerema and Magu District Hospitals were trained on Cervical biopsy collection as  pilot sites.

Results

A total of 48(96%) Cervical Biopsy samples were collected out of 50 women with suspected cervical lesions the 2 women did not turn up for biopsy collection after screening. Of the 48 biopsy samples, 26(54%) results were obtained and18(69%) were cancerous; 7 Women were traced and given results and are on treatment, while 11 women have not received their results. The other 22 biopsy samples awaiting laboratory confirmation.

Figure 1: Biopsy samples ready for packing to be transported to Bugando Medical Centre

Figure 2: CECAP provider providing cryotherapy services at Maswa District Council, Simiyu region.

Figure 3: CECAP provider fixing cryomachine in Bunda District Council, Mara region.

Conclusion and Recommendation

The study results show that nurses can be trained to conduct a safe Cervical Punch Biopsy and at the same time reducing the human resource gap.

References

  • Tanzania Service Delivery Guidelines for Cervical Cancer Prevention and Control 2011
  • Fiander AN, Cervical screening in Young women aged 20-24 years 2008; 34:19
  • IARC Working group on cervical cancer screening for squamous cervical cancer.
  • AGPAHI CECAP Quarterly Reports 2016/2017.

 

What We Do

  • TB in the Mining Sector Programme +

    TB in mining sector (TIMS) project is funded by Global fund through Development Aid from People to People (ADPP - Mozambique). AGPAHI is a sub-recipient of ADPP Mozambique.The project target is to screen TB to approximately 30,000 mine workers and their families.

  • Provision of Comprehensive HIV Care +

    The purpose of** Boresha Project** is to support comprehensive facility-based HIV testing, care, treatment and support service provision in 9 scale-up and 25 sustained districts in the five lake zone regions of Geita, Mara, Mwanza, Simiyu and Shinyanga. .

  • CIFF Reprogramming +

    Project Goal is to improve health services to prevent HIV transmission, increase identification of adolescents with HIV infection, and improve HIV care and treatment and retention for ALHIV in Tanzania.

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