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Mobile colposcopy by trained nurses in a cervical cancer screening programme at Battor, Ghana

Kofi Effah
Mawusi C. Wormenor
Ethel Tekpor
Joseph E. Amuah
Hayford B. Atuguba
Essel N. O. Mensah
Ewoenam S. Badzi
Stephen Danyo
Dominic Agyiri
Gifty B. Klutsey
Patrick K. Akakpo


Objectives: Cervical precancer screening programs are difficult to establish in low resource settings partly because of a lack of human resource. Our aiming was to overcome this challenge. We hypothesized that this could be done through task shifting to trained nurses.
Design: Descriptive retrospective cross-sectional review.
Setting: Training was at the Cervical Cancer Prevention and Training Center (CCPTC) and screening was carried out at the clinic and at outreaches / peripheral facilities.
Participants: All women who reported to the clinic for screening or were recruited during outreaches
Interventions: All 4 nurses were trained for at least 2weeks (module 1). A total of 904 women were screened by the trained nurses using the EVA system. Quality assurance was ensured.
Main outcome measures: Primary screening and follow-up were carried out by the trained nurses with quality assured through image sharing and meetings with peers and experienced gynaecologists.
Results: 828 women had primary screening and 76 had follow-up screening. 739 (89.3%) were screened at the clinic and 89 (10.7%) at outreaches/peripheral facilities. Of all screened, 130 (14.5%) had cervical lesions, and 25 (2.8%) were treated, 12 (48.0%) by Loop Electrosurgical Excision Procedure (LEEP) performed by a gynaecologist, 11 (44.0%) with thermal coagulation by trained nurses except one, and 2 (8.0%) with cryotherapy by trained nurses.
Conclusion: We demonstrate the utility of a model where nurses trained in basic colposcopy can be used to success-fully implement a cervical precancer screening and treatment program in low-resource settings.

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print ISSN: 0016-9560