- Cervical cancer is the second most common cancer among women in Kenya.
- Current estimates indicate that every year 5,236 women are diagnosed with cervical cancer and 3,211 die from the disease.
Image: PSCU
Most dispensaries and health centres in Kenya do not offer cervical cancer screening, and even those that do, they fail to provide basic treatment, a new study supported by the Ministry of Health indicates.
These gaps mean hundreds of women could benefit but do not.
Cervical cancer is the second most common cancer among women in Kenya.
Current estimates indicate that every year, 5,236 women are diagnosed with cervical cancer and 3,211 die from the disease.
Experts say it is one of the most successfully treatable forms of cancer, as long as it is detected early and managed effectively.
Officials from the Ministry of Health, the Aga Khan University Hospitals and their partners assessed 3,150 hospitals in 25 counties for their capacity to screen and treat cervical cancer.
The results indicate majority are not prepared, which means Kenya is far from the key targets it must meet by 2030 to eliminate the disease.
The key two main targets are vaccination against HPV and screening with a high-precision test, and linkage to treatment.
“Cervical precancer lesions treatment availability is limited in the hospitals surveyed, which may reduce successful care linkage for women with positive screening results,” the study notes.
The study, titled "Baseline Assessment of Cervical Cancer Screening and Treatment Capacity in 25 counties in Kenya, 2022," was published recently in the Frontiers Journal.
It noted cervical cancer screening was available in 1,665 hospitals (52.6 per cent). However, only 166 (5.3 per cent) were offering both screening and treatment for cervical cancer.
However, less than 50 per cent of dispensaries and health centres, where most Kenyans seek services first, provide screening.
The assessment was carried out from February 2021 to January 2022. The study population was hospitals, from Level 2 (dispensaries) to Level 6 (national referral hospitals) in the target counties.
There was also a lack of trained and competent personnel.
Only 10.8 per cent of healthcare workers were trained in cervical cancer screening and treatment.
“While some healthcare workers reported they had received training in the past, some did not feel competent enough to offer treatment. Another reason could be erratic provision of screening and treatment health commodities and unavailability of treatment equipment,” the study says.
They said the readiness of hospitals to provide cervical cancer screening and treatment services was also hampered by erratic provision of health commodities.
"Despite a country-wide distribution of cryotherapy equipment over a decade ago, many hospitals either had broken equipment or had run out of cryotherapy gas and never replenished," the study reveals.
Screening cervical cancer is simple and can be done through the naked-eye examination of the uterine cervix after swabbing with acetic acid.
However, the study found that less than half of the hospitals had available stock of cervical cancer screening and treatment commodities at the time of the survey.
"Procurement of such commodities may not be prioritised at the county level, compared with diagnostic commodities and medicines," the authors state.
“The unavailability of essential supplies such as acetic acid, cryotherapy gas, and HPV kits is a significant barrier to effective cervical cancer screening and treatment.”
The authors include Dr Mary Nyangasi, head of the cancer control programme at the Ministry of Health.
The other authors are from the ministry, Clinton Health Access Initiative, Belgian Cancer Centre, Ghent University Hospital of Belgium, Cancer Research Institute Ghent and the Aga Khan University.
Despite these challenges, the presence of multiple screening points within hospitals was identified as a key strength of the cervical cancer programme.
"Multiple service provision points by different cadres minimise lost opportunities and increase screening uptake," the study notes.
The integration of cervical cancer screening services into maternal and child health and HIV clinics has proven effective, offering a model for expanding service provision to outpatient departments and gynaecological clinics.
“To meet the 2030 elimination targets, the national and county governments should ensure adequate financing, training and service integration, especially at primary care level,” the authors said.
The study also calls for a comprehensive human resource development plan to guide recruitment, training, mentorship, retention and replacement of healthcare workers at the county level.
"Sustained capacity-building of healthcare workers is necessary for the success of cervical cancer programmes," the authors recommend.