Table 2.
Facilitators, barriers and proposed solutions to increase CHC-based HPV testing in six communities in Migori County, Kenya.
| Oyani | Ongito | Nyarongi | Nyamanga | Obware | Agenga | |
|---|---|---|---|---|---|---|
| Sub-county | Suna East | Uriri | Suna East | Nyatike | Nyatike | Nyatike |
| Primary source of income | Farming | Farming | Farming | Farming + fishing | Farming | Farming + mining |
| Facilitators | ||||||
| Facilitators across all communities | Door-to-door mobilization Key stakeholder engagement Adequate staffing Proper logistics + technical support |
|||||
| Community-specific facilitators | Campaigns held in non-harvesting season | Campaigns held in non-harvesting season | Use of PA system | Use of PA system | Use of PA system | 1. Use of PA system 2. Other events/health campaigns complemented CHCs |
| Barriers | 1. CHCs occurred on market days 2. Cervical cancer screening campaigns by other groups a few months before CHCs |
1. Religious/cultural beliefs 2. Previous cervical cancer screening with VIA/VILI led to fear and reluctance to screen |
1. Farming activities during CHCs 2. Weather (rain) |
1. Fishing activities during CHCs 2. Cervical cancer screening campaigns by other groups a few months before CHCs |
1. CHCs occurred on market days 2. Weather (rain) |
CHCs occurred on market days |
| Potential future strategies | ||||||
| Solutions applicable to all communities | Involve CHVs early and through CHCs for logistical planning | |||||
| Community-specific solutions | 1. Hold CHCs on non-market days or adjacent to markets 2. Hold CHCs later in the day or on non-work days 3. Collaborate with other partners |
1. Greater engagement with religious/community leaders before CHC 2. Improve coordination with the CHMT and SCHMT before CHCs |
1. Hold CHCs later in the day or on non-work days 2. Plan CHCs during non-harvesting season 3. Screen through home visits or clinics in areas with low screening uptake |
1. Hold CHCs later in the day or on non-work days 2. Hold CHCs next to fishing sites 3. Collaborate with other partners |
1. Hold CHCs on non-market days or adjacent to markets 2. Hold CHCs later in the day or on non-work days 3. Screen through home visits or clinics in areas with low screening uptake |
1. Hold CHCs on non-market days or adjacent to markets 2. Hold CHCs later in the day or on non-work days |
| Cost per woman screened (USD) | 23.98 | 30.21 | 26.39 | 26.21 | 23.81 | 22.06 |
| Women screened (n) | 601 | 337 | 461 | 430 | 483 | 586 |
| Proportion of population (%) | 60 | 52 | 53 | 40 | 72 | 100 |
Abbreviations: CHC, community health campaign; CHMT, Community Health Management Team; CHV, community health volunteer; PA, public address; SCHMT, Sub-County Health Management Team.