Objective. To develop and implement a community based model for cervical cancer prevention that allows the
communities to manage the screening and the healthcare system to focus resources on evaluation and management
of the positives.
Methods. Using self-sampling and the concepts founded in Community Based Participatory Research (CBPR),
we progressively developed a model to efficiently reach the women, especially rural communities; and collect
the volume of samples needed to support high throughput centralized low cost per case processing.
Results. 8382 eligible women, ages 35 to 59, in 130 rural communities participated. The screening was organized
by the local government administration and conducted by the community leaders (CLs). The model used
was progressively designed through detailed assessment of key elements at 6 decision points in 26 workshops
that were used to train the CLs and the local promoters. The communities were able to accurately conduct the
screening; in the final model a local medical worker conducted a 50-minute workshop featuring instructional
posters and structured role-play. A manual and a workshop DVD were created for distribution to and implementation
by local governments. The average callback rate was 84.3%, without involvement of the local doctors in the
management of the positives.
Conclusion. An efficient community based model capable of massive screening events was developed. We
believe that the callback rate will be further improved when local doctors are trained in the management of
the positives. Many elements impact coverage and further research is needed to define the influence of the identified
key variables