Communicating Scientific Findings to Communities With High Risk and Best Ways to Do That is a Challenge

Abstract

Background: A national cytology cervical cancer screening program was introduced in South Africa as part of cancer control program policy more than a decade ago. Policy guidelines state that women attending the public sector services are entitled to three free Pap smears per lifetime starting at the age of 30 years or older, with a 10 year interval between each smear. However, the frequency in which women come for Pap smears is very low, with some getting diagnosed when the disease is at its advance stage. Consequently, cervical cancer incidence rates are very high with low survival rates. Fragmented evaluation of this program done in different provinces revealed that women lacked knowledge about cervical cancer. Women are also uninformed about the free national cytology cervical cancer screening. Furthermore, there is scarcity or no free public screening services especially in rural populations. In 2014, the National Health Ministry started HPV vaccination to girls at ages 11 years in schools. The expectation was that providing vaccines to young girls will reduce cervical cancer and its associated mortality in the next two to three decades. However, commitment to reduce the burden of cervical cancer should continue. Furthermore, it is important to intensely introduce health-seeking behavior to the population at high risk through community engagement and education around cervical cancer. This will reinforce early detection and prevention initiative thus reducing premature deaths due to this cancer and improving quality life. Aim: In 2017 a partnership between Committee of Health Programs under rural development and scientists of the South African Medical Research Council was initiated. This committee's mandate is managed by the Provincial House of Traditional Leaders in the Eastern Cape. Specific objectives include forming partnership with traditional leaders as key role players in reducing cervical cancer morbidity and mortality. As well as, to reduce high incidence of cervical cancer in the rural high-risk population. Methods: Eight villages were identified for intervention. Primary health clinic nurses working in identified villages were included to work as part of the team that will deliver the interventions. Intervention activities will include providing education about cervical cancer which will be done through awareness campaigns twice a year for the next 5 years. Another component of the intervention will be voluntary cytology screening for cervical cancer for all enrolled participants. Voluntary participants will form a cohort for follow-up. After five years the intervention will be evaluated. Conclusion: It is envisaged that this intervention initiative will be expanded to other provinces in South Africa.