African Journal of Public Health and Health Systems | 07 March 2011
Evaluating the Effectiveness of a Mobile Van-Based Cervical Cancer Screening Programme Using Visual Inspection with Acetic Acid in Rural Manicaland, Zimbabwe
T, e, n, d, a, i, M, o, y, o, ,, R, u, d, o, C, h, i, k, w, a, v, a, ,, F, a, r, a, i, C, h, i, g, u, d, u
Abstract
Cervical cancer is a leading cause of cancer-related mortality among women in Zimbabwe. Access to screening in rural areas remains low due to geographical barriers and the limited reach of static health facilities. This study evaluated the effectiveness of a mobile van-based programme using visual inspection with acetic acid (VIA) in increasing cervical cancer screening uptake and case detection in rural Manicaland, Zimbabwe. An intervention study was conducted. A mobile van equipped for VIA screening visited selected rural villages on a scheduled rotation. Women aged 25–49 were recruited through community health workers. Screening uptake, VIA positivity rates, and referral completion were measured and compared to pre-intervention baseline estimates from static clinics in the same catchment areas. The programme screened 1,247 women. This represented a threefold increase in the monthly screening rate compared to the baseline period. The VIA positivity rate was 8.2%. Of those who tested positive, 76% attended their referral appointment for further assessment or treatment at the district hospital. The mobile van-based approach effectively increased cervical cancer screening coverage in this hard-to-reach rural population. It facilitated the detection of pre-cancerous lesions and proved feasible in a resource-limited setting. Scale-up of mobile VIA screening should be considered within the national cervical cancer control strategy. Future programmes require integrated referral pathways and sustained community engagement to ensure follow-up care. Further research should assess the long-term impact on disease incidence and mortality. cervical cancer screening, visual inspection with acetic acid, mobile health units, rural health services, Zimbabwe, implementation research This study provides empirical evidence from Zimbabwe on the implementation and outcomes of a mobile van-based cervical cancer screening strategy.