Women aged over twenty-nine years are screened using visual inspection after acetic acid application by trained paramedics. Independent consultants not involved in strategic planning or implementation of the program were engaged to review the ongoing activities. They visited different service delivery set-ups, collected data using a structured proforma, interviewed the service providers, and held discussions with the program managers. This paper summarises the observations and recommendations of the experts performing the quality control process.
The study concluded that the program mostly opportunistic screening with good central co-ordination and some elements of organized screening. The coverage of the target population at the end of four years was deficient. The colposcopy compliance was good, though nearly half of the patients with high-grade precancers did not receive treatment. Cryotherapy was infrequently used, and a policy was rarely followed. No strategy for internal monitoring and quality control was built into the program. The reviewers enumerated the quality assurance standards at various service delivery levels based on which the performance assessment can be done periodically. It is the first evaluation report of a VIA-based national cervical screening program.
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