In support of the WHO 2030 goal towards the elimination of cervical cancer as a public health problem, Unitaid-CHAI seek to accelerate access and scale up the use of optimal tools through the cervical cancer prevention program in Nigeria. The program is working in close collaboration with the Federal and State Ministries of Health in Lagos, Rivers and Kaduna states to screen and treat 430,000 women in two years. The goal of the program is to scale up routine screening and treatment of pre-cancerous lesions across public health facilities in the country.
In Nigeria, access to effective secondary prevention has been constrained by some factors including low disease awareness, lack of routine screening and treatment, lack of trained personnel, and cumbersome treatment methods. This phase of the program is focused on addressing these critical barriers to access with targeted efforts on demand generation, capacity building of healthcare workers, screening and diagnosis, appropriate treatment, and establishing robust patient tracking systems in country.
So far, approximately 80,000 women have been screened. Insights from program data shows an overall positivity rate of 5.5%. with HPV positivity being significantly higher in WLHIV; and most prevalent in the 35-39 age group for WLHIV with 17% positivity rate.
Some of the key lessons learned from program implementation include:
1. Integration of cervical cancer screening and treatment into existing health services provides immediate entry points
2. Adequate provision of consumables and supplies is crucial for the success of any screen and treat program
3. Same day screen and treat to be implemented where feasible to reduce loss to follow up
4. Continuous on the job training and mentoring for HCWs is important
5. HPV self sampling is the most practical screening method with the COVID-19 pandemic
6. Strengthened national M&E system is required to monitor national progress