A Scoping Review of Task-Shifting Models for Cervical Cancer Screening: Nurse-Led Visual Inspection with Acetic Acid in Primary Healthcare Centres in Enugu State, Nigeria

Cervical cancer is a leading cause of mortality among women in Nigeria. A critical barrier to reducing this burden is the severe shortage of specialist physicians in primary healthcare settings. Task-shifting, the delegation of clinical tasks to non-physician healthcare workers, has been proposed as a strategy to expand access to screening services. This scoping review aimed to map and synthesise evidence on the implementation and outcomes of a specific task-shifting model for cervical cancer screening in Enugu State, Nigeria. The model involves nurses performing visual inspection with acetic acid in primary healthcare centres. A scoping review was conducted, guided by established frameworks. A systematic search was performed across multiple electronic databases and grey literature sources. Studies, reports, and programme evaluations relevant to the model were included. Data were charted and analysed thematically. The review identified a limited but consistent body of evidence. Findings indicated that the nurse-led model was feasible and acceptable within primary healthcare. A key theme was the significant increase in screening coverage following implementation. Challenges identified included initial gaps in nurse competency and supply chain issues for essential commodities. Task-shifting cervical cancer screening to nurses using visual inspection with acetic acid appears a viable approach to mitigate workforce shortages and improve service access in Enugu State. The model demonstrates potential for integration into routine primary healthcare. Further operational research is needed to standardise training and address logistical barriers. Policymakers should consider formal adoption and scale-up of the model, supported by sustainable financing and robust monitoring systems. Task-shifting, cervical cancer screening, visual inspection with acetic acid, nurse-led, primary healthcare, Nigeria. This review consolidates available evidence on a nurse-led task-shifting model for cervical cancer screening in a Nigerian context, informing policy and practice discussions for scaling up screening access.