Noncommunicable Diseases
- Is It Time to Move Beyond Visual Inspection With Acetic Acid for Cervical Cancer Screening?
Newly emerging low-cost molecular assays and improved visual tests for cervical cancer screening call into question the role of visual inspection with acetic acid (VIA). VIA-based screening continues to offer a low-cost, single-visit approach for screening. However, VIA is highly rater-dependent and has problematic accuracy. RNA, DNA, and protein tests are now available. They offer greater accuracy and the option for self-sampling, but the testing kits are expensive. As these new options continue to improve, the time to move beyond VIA is fast approaching.
- Expanding the Single-Visit Approach for Cervical Cancer Prevention: Successes and Lessons From Burkina Faso
The single-visit approach was implemented with strong attention to systems in 14 health facilities. In the 2 largest facilities, nearly 14,000 women screened for cervical cancer over 4 years. Of approximately 9% who screened positive, about 66% received same-day cryotherapy. Attention is needed to ensure local technicians can repair cryotherapy equipment, supplies are consistently in stock, and user fees are not prohibitive to accessing care.
- An NGO-Implemented Community–Clinic Health Worker Approach to Providing Long-Term Care for Hypertension in a Remote Region of Southern India
Paid community health workers screened for hypertension in the community, referred cases to the clinic for diagnosis and initial treatment by a physician, and then monitored patients who had well-controlled blood pressure including dispensing maintenance medications prescribed by the physician. Blood pressure control was successful in the majority of such patients.
- Community-Based Noncommunicable Disease Care for Syrian Refugees in Lebanon
The high prevalence of noncommunicable diseases (NCDs) among Syrian refugees in Lebanon required a shift in the humanitarian response, from direct care provided through mobile medical clinics to community-based primary health care and health promotion provided through trained refugee outreach volunteers (ROVs). During the first 2 months after training, these ROVs conducted 753 blood pressure monitoring visits and 657 blood glucose checks; monitored medication adherence among 387 patients with NCDs; referred 293 refugees to the local primary health care facility for additional care; and provided 346 targeted health education messages.
- The Single-Visit Approach as a Cervical Cancer Prevention Strategy Among Women With HIV in Ethiopia: Successes and Lessons Learned
With the single-visit approach for cervical cancer prevention, women with positive “visual inspection of the cervix with acetic acid wash” (VIA) test results receive immediate treatment of the precancerous lesion with cryotherapy. The approach worked successfully for women with HIV in Ethiopia in secondary and tertiary health facilities, with high screening and cryotherapy treatment rates. Sustainability and appropriate scale-up of such programs must address wider health system challenges including human resource constraints and shortage of essential supplies.
- Major challenges to scale up of visual inspection-based cervical cancer prevention programs: the experience of Guatemalan NGOs
Scale up of visual inspection with acetic acid (VIA) in Guatemala encountered major challenges, including high attrition of people trained, didactic training without hands-on skills building, lack of continued supervision, and provision of VIA alone without immediate on-site provision of cryotherapy.