Integrating Visual Inspection with Acetic Acid into Family Planning Services: A Case Study of Cervical Cancer Screening in Nairobi, Kenya

Cervical cancer is a leading cause of cancer-related mortality among women in Kenya, yet screening coverage remains low. Family planning clinics present a strategic, underutilised opportunity to reach a large population of women within the target age group. This case study documented the operational feasibility, challenges, and initial outcomes of integrating visual inspection with acetic acid (VIA) cervical cancer screening into existing public family planning services in Nairobi. An operational research approach was employed across three public family planning clinics. Data were collected via integrated service records, structured observations of clinic workflows, and key informant interviews with clinic managers and nurses trained in VIA provision. Integration was operationally feasible but required adaptations to clinic flow and counselling protocols. A key outcome was that over 80% of eligible women attending family planning consultations accepted VIA screening when offered. Nurses reported initial hesitancy which was overcome with training and mentorship. A primary operational challenge was maintaining consistent supplies for VIA and the treatment of pre-cancerous lesions. Integrating VIA screening into family planning clinics is a viable strategy to increase cervical cancer screening uptake in an urban African setting, leveraging existing infrastructure and client trust. Programmes should invest in targeted training and supportive supervision for family planning providers. Supply chains for essential commodities must be strengthened. Further research should assess the long-term sustainability and cost-effectiveness of this integrated model. cervical cancer screening, visual inspection with acetic acid, service integration, family planning, operational research, Kenya This case study provides practical, evidence-based insights for programme managers and policymakers in sub-Saharan Africa seeking to implement integrated cervical cancer prevention services within existing primary healthcare platforms.