Putting Evidence into Practice: Dissemination and Implementation of a Cervical Cancer Prevention Project in Ethiopia

Purpose: Cervical cancer incidence rates are astonishingly high among women in Ethiopia (35.9 per 100,000).  Almost 6,000 Ethiopian women die annually from the disease. In developed countries, cervical cancers are prevented by early detection using the Papanicolaou (Pap) test; however, in low resource countries, Pap tests are not readily available. An evidence-based alternative, low-tech approach to preventing cervical cancer using visual inspection with acetic acid (VIA) and cryotherapy has successfully reduced morbidity and mortality from cervical cancer in India and Uganda.  Dissemination and implementation (D & I) of this evidence-based procedure can save women’s lives when cancer treatment and providers are scarce.  

Methods: We will detail the process of: 1) partnership building with an academic institution and non-governmental organizations in Gondar, Ethiopia for D & I of a VIA program, and 2) building capacity of a nursing program at a partner academic institution by training nurses and midwives in D & I of VIA procedures. We also describe the challenges of conducting a cancer prevention project in a global health setting.

Results: High degree of communication and collaboration between institutions are critical in implementing a cancer prevention program. Challenges include communication with in-country staff, competing international cancer prevention programs, high cost of using a standardized cervical cancer screen and treat curriculum, and cultural and linguistic differences.

Conclusion: D & I of an evidence-based screen and treat program for cervical cancer with nurses in low-resource settings is critical in countries with limited assets and skilled human capital.  Enhancing the skills and competency of nurse faculty and students to conduct VIA can eliminate the burden of cervical cancer and untimely death of thousands of Ethiopian women.  This presentation offers new insight into building capacity of nursing programs in a global context and provides guidance on carrying out global health research.