The Zimbabwe Health Interventions (ZHI) Accelerated and Comprehensive HIV Care for Epidemic Control in Zimbabwe (ACCE) project collaborated with the Ministry of Health and Child Care (MOHCC) and Clinton Health Access Initiatives (CHAI) to pilot Human Papilloma Virus deoxy-ribonucleic acid (HPV DNA) testing in Makoni district. Makoni district has only two Visual inspection with acetic acid and cervicography (VIAC) static health facilities (Rusape General Hospital and Headlands clinic) which provides screening services daily and more than 50 outreach health facilities around the district to reach more than 5000 women living with HIV aged between 25 and 49 years who need cervical cancer screening and treatment services.
The HPV DNA testing services were introduced in the district as a pilot where 20 health facilities had nurses trained to mobilize and collect samples from clients within their catchment areas to increase targeted screening. Eleven ZHI HIV care and treatment officers were also trained on HPV DNA testing service delivery. The USAID/ZHI supported cervical cancer officer together with MOHCC and CHAI offered technical support to monitor HPV DNA testing services (collection of samples from mobilized clients at clinic level, sample transportation leveraging on viral load integrated sample transportation already in place to transport samples from sites to the hub). The Medical superintended, District Medical Officer (DMO) and District Nursing Officer (DNO) were trained in HPV DNA screening with support from ZHI and supported in getting MOHCC staff to do sample collection following training, (oversight role).
32-year-old Savana Dube from Rukweza village, in Makoni district, is one of the women living with HIV who were screened with VIAC following DNA HPV positive results. She was also treated for precancerous lesions using cryotherapy.
“I never thought I could get the cervical cancer screening and treatment services for free at the nearby health facility, said Savana. I will definitely honour my review dates and also encourage other women to get screened.”
Her husband was equally grateful, “I am happy that my wife was screened and treated for pre-cancerous lesions at no cost. I will take the word to my male counterparts and encourage them to take their wives for cervical cancer screening.”
Marian Makate was screened for cervical cancer at Nyazura clinic: “I appreciate the nurse who screened me for cervical cancer. She took her time to explain the procedure and its benefits. The procedure was short and painless, I was relieved that my sample results were negative.”
Sungano Ticharwa (49 years) who collected her negative sample results from Rukweza clinic echoed Marian’s sentiments: “the nurse was friendly and patient. I hope the program will be extended to all the districts for women to benefit.”
HPV DNA testing was well received and accepted by communities in Makoni district. The partnership between ZHI, MOHCC and CHAI enabled decentralisation of cervical cancer screening and treatment services to the lowest levels of health care. It also improved coverage of targets as well as making the service accessible to women in the rural communities. More women are now demanding the service!