title: Translating evidence into practice in low resource settings: cervical cancer screening tests are only part of the solution in rural India.
abstract: BACKGROUND
  The majority of women in rural India have poor or no access to cervical cancer screening services, although one-quarter of all cervical cancers in the world occur there. Several large trials have proven the efficacy of low-tech cervical cancer screening methods in the Indian context but none have documented the necessary components and processes of implementing this evidence in a low-resource setting.
  
  
  METHODS
  This paper discusses a feasible model of implementation of cervical cancer screening programme in low-resource settings developed through a pilot research project carried out in rural Tamilnadu, India. The programme used visual inspection of cervix after acetic acid application (VIA) as a screening tool, nurses in the primary care centres as the primary screeners and peer educators within Self-Help Women groups to raise community awareness.
  
  
  RESULTS
  The uptake of screening was initially low despite the access to a screening programme. However, the programme witnessed an incremental increase in the number of women accessing screening with increasing community awareness.
  
  
  CONCLUSIONS
  The investigators recommend 4 key components to programme implementation in low-resource setting: 1) Evidence-based, cost-effective test and treatment available within the reach of the community; 2) Appropriate referral pathways; 3) Skilled health workers and necessary equipment; and 4) Optimisation of health literacy, beliefs, attitudes of the community.
authors.affiliation: RUHSA Department, Christian Medical College, Vellore, India. rita.isaac@cmcvellore.ac.in
authors.forename: Rita
authors.initials: R
authors.lastname: Isaac
authors.forename: Madelon
authors.initials: M
authors.lastname: Finkel
authors.forename: Ian
authors.initials: I
authors.lastname: Olver
authors.forename: I K
authors.initials: IK
authors.lastname: Annie
authors.forename: H R
authors.initials: HR
authors.lastname: Prashanth
authors.forename: J
authors.initials: J
authors.lastname: Subhashini
authors.forename: P N
authors.initials: PN
authors.lastname: Viswanathan
authors.forename: Lyndal J
authors.initials: LJ
authors.lastname: Trevena
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer; D055317:Evidence-Based Practice; D005260:Female; D015438:Health Behavior; D006295:Health Resources; D006801:Humans; D007194:India / Q000453:epidemiology; D008875:Middle Aged; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D012424:Rural Population; D057170:Translational Research, Biomedical; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control