Partnering with community health promoters associated with coffee cooperatives to address barriers to effective cervical cancer prevention in rural communities

Grounds for Health (GFH), a US-based NGO, partners with coffee cooperatives and local health authorities to improve cervical cancer prevention services, increase access, and reduce loss to follow-up. In Nicaragua and Mexico, cervical cancer ranks among the two most common causes of cancer death. Though it is preventable, women in rural regions face numerous barriers to access. GFH utilizes an innovative model that includes training local providers in screen-and-treat techniques and working with community health promoters (CHP) to address these barriers at the community level. Between 2007 and 2012, GFH collaborated with ten coffee cooperatives to mobilize communities around cervical cancer prevention. GFH and the co-ops trained 356 CHPs associated with the co-ops from 60 communities in Chiapas, Mexico and 112 communities in Jinotega, Matagalpa and Madriz, Nicaragua. During this period, 16,266 women were screened for cervical cancer using Visual Inspection with Acetic Acid. Of the screen positive women, 70% received appropriate treatment within three months. Semi-structured interviews with community members, co-op staff, and local providers highlighted the important role played by CHPs. CHPs reduced barriers to screening and treatment at the community level by raising awareness and reducing stigma, dispelling myths and fears, accompanying women to care, and coordinating with providers to ensure follow-up care.