This document outlines a 4-year cervical cancer screening and treatment project in Kenya funded by the Bill & Melinda Gates Foundation. The project aimed to screen 645,910 women ages 30-49 for cervical cancer and provide preventative treatment to 51,000 eligible women through partnerships with 3 organizations operating 380 screening sites and 52 treatment sites. Key results included screening over 203,000 women ages 30-49 for cervical cancer and finding 3,853 women positive and eligible for treatment. Lessons learned emphasized the importance of addressing barriers to follow-up treatment like distance, cost, and fear to improve health outcomes.

1. CERVICAL CANCER SCREENING AND PREVENTATIVE
TREATMENT (CCS PT) THROUGH THE PRIVATE SECTOR
By: Rachel M Mutuku
Senior Manager Reproductive Health - PS Kenya

2. OUTLINE
 The Project
 The partners
 Where we work
 How we work
 Results
 Experiences

3. THE PROJECT
 4 year project (Nov 2012-Oct 2016).
 Funded by Bill & Melinda Gates Foundation.
 General population project targeting women at
highest risk age bracket 30-49 yrs. (Kenya WRA 25-
49yrs) across Kenya.
 Indicators:
 Cervical Cancer Screening (VIA/VILLI) & referring lesion of any size
 Cervical Cancer Screening (VIA/VILLI) & treating lesions <=75%
 Cervical Cancer Screening (VIA/VILLI) & referring lesions >75%

4. THE PROJECT CONT.…
 Result areas:
 Scale up of screening services: 645,910
 % positive after VIA
 % eligible and receive PT: 51,000
 Follow ups and referrals
 Quality assessments

5. KENYA IMPLEMENTING PARTNERS
 Consortium of 3 organizations- PS Kenya,
Mariestopes Kenya and FHOK.
 Implementing through our social franchises (Amua
clinic, Tunza clinic) and through FHOK clinics.
 380 static screening sites and 52Treatment
sites.

6. IMPLEMENTATION
 Through our existing reproductive health
networks.
 Employ different delivery models- outreaches/in
reaches.
 Service delivery is supported by a strong training
component- TOT/ Cascade training.
 There is community education and mobilization
creating foot traffic to the clinics.

7. IMPLEMENTATION CONT…
REFERRAL PATHWAY

8. WHERE WE WORK
Treatment sites

9. RESULTS
 No of CC screenings in 30-49 age group: 203,014
 No of women screened, positive and eligible (All age-groups): 3,853

10. EXPERIENCES
A blend of models works: Static clinics v outreaches
Static clinics
 Need for greater demand generation on the service area
including cross selling .
 Strategize on the optimization of the Cryo machines.
Outreaches
 Greater demand for services.
 Greater access and response to equity.
 Targeting appropriate age group.
 Smaller gas cylinders needed to achieve SVA via outreach.

11. EXPERIENCES CONT…
With a Hub and Spoke approach it is critical to have
strategies to mitigate loss to follow up:
Subsidized and/or free treatment available via
RHNs.
Explore provider incentives.
 Vouchers.

12. EXPERIENCES CONT…
Mitigate barriers to 100% follow up and treatment:
Communication: Client oriented, Male involvement.
Distance and Time.
Fear.
Health facilities oriented
Cost of services .
No service providers for cryotherapy.
Strategies adopted to minimize loss to follow up
Referral directories .
Use of CHVs to reinforce referrals.
Use of Call Centers for follow up.

13. EXPERIENCES CONT…
Strategies to safeguard quality:
Supplies for use in VIA VILLI including equipment used-timers
and light source.
Quality advisors/mentors on CCS PT-external QA.
CCS PT quality Checklist and integration in to routine quality
technical assessments.
Need to understand what Kenyan positivity rate is.

14. PICTORIAL
KISII: Dr. Mageto, Sameta District DMOH
(left) introducing CHMT to the DHMT KAPSABET: Meswo Clinic proprietors pose for
photo with Guest of honor Dr. Okoth, Nandi
County Director of Health & CHMT
Enthusiastic crowd gather at the
clinic to be the first beneficiaries
of the newly donated machine
Training-Thika