Screen smarter, prevent better: Empowering women against HPV and cervical cancer.
Human papillomavirus (HPV) is a viral infection that spreads through intimate skin-to-skin or skin-to-mucosa contact. It is among the most prevalent sexually transmitted infections globally, with over 90 percent of sexually active men and 80 percent of sexually active women expected to be infected at some point in their lives. Though these percentages are high, the body is capable of controlling the infection by itself in 90% of cases. Persistent infection with high-risk HPV types can result in more severe consequences beyond itching and warts, such as cervical cancer. Due to anatomical differences resulting in thicker tissue around the uterus and vagina, as well as hormonal influences that can alter the immune system, women are more susceptible to HPV that can turn into cervical cancer.
Currently, India faces notable health issues due to HPV, affecting 5% of women aged 18 to 59 in a population of 1,000. This consequently results in an age-standardized incidence rate of 14.7 per 100,000 women for cervical cancer. As the second most common cancer among women in India, cervical cancer exhibits significantly higher prevalence rates in rural areas compared to urban settings (10.5% versus 4.5% respectively).
Consequently, initiatives have been made to address HPV infection and cervical cancer. For example, starting from February 2024, the Indian Government has initiated the allocation of funds and efforts to ensure that all girls aged 9 to 14 receive the HPV vaccine in order to prevent the development of cervical cancer.
"India faces notable health issues due to HPV, affecting 5% of women aged 18 to 59 in a population of 1,000. This consequently results in an age-standardized incidence rate of 14.7 per 100,000 women for cervical cancer."
PHRII works intensively in screening, counselling, and educating women about HPV. It actively engages with communities, particularly in underserved areas like slums and villages, to ensure that women have access to these essential services without any financial burden. Through their dedicated efforts, PHRII not only raises awareness about HPV but also empowers women with knowledge that can potentially save lives. By reaching out to these marginalized communities, they are bridging the gap in healthcare disparities and making a significant impact on the overall well-being of women.
I had the opportunity to take part in one of PHRII's mobile clinics for HPV, during which our team visited a local slum. Similar to the Gender-Based Violence (GBV) project, our initial task was to establish our setup and encourage women to attend. The assistance of the ASHA workers, trusted members of the community, greatly facilitated this process.
The first station of the HPV mobile clinic was handled by staff nurses who recorded the women's blood pressure, age, waist size, and height for biometric registration. These details serve as identification data during the collection of their HPV test outcomes.
Dakshayini (Outreach worker; pink and red kurta) and Rani (coordinator/staff nurse; pink and white kurta) taking biometric measurements
At the second station, the women were informed about the aims of the mobile clinic, as well as given a concise explanation about HPV and cervical cancer, emphasizing the significance of screening and treatment. This was an important step as HPV is a taboo subject that is associated with many misconceptions—one being that the HPV vaccine causes the infection itself. Therefore, it was essential to reassure the women and offer them correct, factual information.
Fazila (counseller/training coordinator; pink and grey kurta) holding an educational group discussion
A gynecologist and lab practitioner performed biomedical examinations on the women at the third station. This involved visual and pelvic inspections, along with instructing the women on how to conduct self vaginal swabs to determine their HPV status.
Dr. Raghavi (OB-GYN; white saree) and Anisa (lab research assistant; black kurta) performing biomedical examinations and collecting self vaginal swabs
Finally, the last station concentrated on counseling. Several PHRII employees engaged in one-on-one/small group discussions with the women to grasp their views on HPV, and provided them with details on reproductive health and available resources.
Education plays a crucial role in these screening visits, as even if a mobile clinic can only reach a limited number of women, those individuals will return to their communities and raise awareness among their friends and family members.
Ms. Rashmi (clinic supervisor/counsellor; blue kurta), Nandini (data entry operator; blue and white kurta), Shivamma (counsellor; pink and black kurta), and Fazila (counsellor/training coordinator; pink and grey kurta) holding counselling sessions
PHRII's mobile clinics play a crucial role in addressing the challenges of HPV and cervical cancer in rural India. These clinics bring essential healthcare services directly to underserved communities, where access to regular medical facilities is often limited. By offering screening, consultation, and early detection programs, PHRII contributes significantly to reducing the incidence and mortality rates associated with HPV which can lead to cervical cancer. Moreover, it enhances awareness about HPV prevention and the importance of regular check-ups among women who might otherwise not seek medical care due to geographical or cultural barriers. Thus, PHRII's mobile clinic initiatives are not just a health imperative but a fundamental step towards achieving equitable healthcare access and improving women's health outcomes in rural India.
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