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Human resources are a general constraint, with a constant need for trainers and skilled health care
workers. In regard to invasive cervical cancer, the capacity for radiotherapy and other tertiary care is
limited. Finally, funding constraints are a basic challenge at all levels, as the strategic plan is not funded
directly by the government. Recommendations include a budget line for cervical cancer prevention in
the MOH budget.
Cervical Cancer Prevention Program in Zambia
Dr. Sharon Kapambwe
Head, Cervical Cancer Prevention Program in Zambia
Center for Infectious Disease Research in Zambia
Dr. Sharon Kapambwe introduced her presentation by reminding the audience that as in most African
countries, women with cervical cancer in Zambia are usually in advanced stages when they seek medical
help. This cancer causes more deaths in women than any other cancer in the country, and is the most
common cancer regardless of gender. The barriers to cervical cancer prevention in Zambia are familiar
and include a general lack of health literacy, competing health needs, and a severe shortage of human
resources.
To overcome these barriers, the Center for Infectious
Disease Research in Zambia has outlined a blueprint for Barriers to cervical cancer
cervical cancer screening using digital cervicography.
prevention in Zambia include a
Because of the shortage of doctors and other trained health general lack of health literacy,
personnel, the program is carried out by nurses. The nurses competing health needs, and a
perform VIA, and a photograph of the cervix taken with a
severe shortage of human
digital camera is displayed on a monitor, where it can be
resources.
used by the nurse for further evaluation, for patient
education or, when sent to a physician, for consultation.
The nurse can provide cryotherapy at once, or can refer the patient for further services.
Since the beginning of the program, 50,000 women have been screened and approximately 10,000 have
been treated for precancerous lesions. One-third of those screened have been HIV-positive.
The Zambian system of "electronic cervical cancer control" bypasses many of the historic barriers to the
delivery of preventive health care to women in low-resource environments while facilitating monitoring,
evaluation, and continued education of primary health care providers, patient education, and medical
records documentation.
Goals for the future include expansion of the program to the national level under government
leadership, incorporation of HPV-based technology (both HPV vaccinations and HPV DNA screening),
and the use of existing community structures, such as traditional marriage counselors, to make the
programs more accessible and acceptable.
Report of an African Regional Meeting on Cervical Cancer: September 2010 37