Best Investment for a Healthier World


Every Woman Everywhere Deserves Cervical Health Screening

Ndiaye, 34, a “see and treat” client at the Donga Health Clinic in Francistown, Botswana. Photo courtesy of Jhpiego/Botswana.

Ndiaye, 34, a “see and treat” client at the Donga Health Clinic in Francistown, Botswana. Photo courtesy of Jhpiego/Botswana.

By Rosinah Dialwa and Bakgaki Ratshaa, Jhpiego

It is long before 8am and nearly 80 women are waiting outside of Donga Health Clinic in Francistown, Botswana, for free, same-day cervical cancer screening and treatment. Nurse Portia Maphalala and her colleagues stand by the door, eager to begin screening women.

“I want to screen as many people as possible and spread the message about cervical cancer prevention,” says Maphalala. “I will encourage women that prevention is so much better than treatment. The earlier they screen, the better.”

Cervical cancer is a disease that while slow-growing, preventable and treatable, kills nearly 750 women across the globe every day. That’s over 260,000 mothers, daughters, sisters and friends who lose their lives each year because of a lack of access to prevention and treatment services.

Eighty-five percent of these deaths happen to women of reproductive age living in low-and middle-income countries. Women who are contributing to their communities and caring for their families.

With a rate of 30.3 new cases per 100,000 women, Botswana’s rate of cervical cancer is nearly twice the worldwide average. This high rate is due in part to the extremely limited availability of screening and treatment programs caused by a shortage of health workers, and in part to the country’s high HIV incidence, which increases the risk of cervical cancer.

The promising news is that we know what works:

  • Reaching girls with a vaccine to protect them from the human papillomavirus (HPV), the cause of almost all cervical cancer cases;
  • For older women, providing HPV testing and increasing access to same-day screening and treatment; and
  • Developing innovations to improve upon current treatment methods and reduce their cost.

Still, as Jhpiego has learned over 20 years of experience in cervical cancer prevention and control programming in 23 countries, all of the evidence-based interventions and innovations we have at our disposal are useless without frontline health workers to support national programs to reach all eligible women and girls.

This includes health workers like Maphalala and her fellow nurses who, over six days, screened 321 women around Francistown. Of those, 60 women were found to have precancerous lesions, and every one of those women who was eligible for same-day treatment received the necessary cryotherapy, effectively halting the progression of cervical cancer.

Jhpiego and Botswana’s Ministry of Health, with support from the President’s Emergency Program for AIDS Relief, the U.S. Centers for Disease Control and Prevention, Pink Ribbon Red Ribbon, and the tireless efforts of frontline health workers, are working to ensure that women in Botswana receive high-quality cervical cancer prevention and treatment services, all in the same visit.

As we mark Cervical Health Awareness Month this January, we must remember the millions of women in underserved communities who do not have access to well-trained frontline health workers to provide lifesaving care, as well as the impact these shortages have on families. Through partnership and a comprehensive approach that increases the number of frontline health workers in remote, vulnerable areas, we can reach all eligible women and girls and put an end to this silent killer once and for all.