title: Evaluation of a 5-year cervical cancer prevention project in Indonesia: opportunities, issues, and challenges.
abstract: OBJECTIVE
  The Cervical and Breast Cancer Prevention (CECAP) Project sought to develop a national model for cervical cancer prevention in Indonesia based on visual inspection with acetic acid (VIA) to detect abnormal changes in the cervix. The purpose of this study was to evaluate a pilot project introducing VIA and cryotherapy in Indonesia and to identify lessons learned that could be applied to the national scale-up of cervical cancer prevention services.
  
  
  METHODS
  Fifty-four months (July 2007 to December 2011) of service records at 17 health centers were abstracted and analyzed. The data were used to calculate the proportion of all women aged 30-50 who received VIA screening, the VIA-positive rate, the treatment rate, and the interval between screening and treatment.
  
  
  RESULTS
  The 45 050 women screened during the project included 24.4% of the total female population in the target age group in the catchment area. Throughout the 5-year project, 83.1% of VIA-positive women sought cryotherapy. During the last 18 months of the project, after data collection tools were revised to more accurately reflect when cryotherapy was received, 13% of women were treated on the same day that they were screened. Among the 74% of women treated within 1 month of screening, the mean interval between screening and treatment was 7.2 days.
  
  
  CONCLUSIONS
  As cervical cancer prevention services are scaled up throughout Indonesia, changes in the service delivery model and program management are needed to increase screening coverage, promote a single-visit approach, and ensure the quality of services.
authors.affiliation: Jhpiego/USA, Johns Hopkins University, 1615 Thames St., Baltimore, MD 21231, USA. ymkim@jhpiego.net
authors.forename: Young-Mi
authors.initials: YM
authors.lastname: Kim
authors.forename: Fransisca Maria
authors.initials: FM
authors.lastname: Lambe
authors.forename: Djoko
authors.initials: D
authors.lastname: Soetikno
authors.forename: Megan
authors.initials: M
authors.lastname: Wysong
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Tergas
authors.forename: Presha
authors.initials: P
authors.lastname: Rajbhandari
authors.forename: Abigael
authors.initials: A
authors.lastname: Ati
authors.forename: Enriquito
authors.initials: E
authors.lastname: Lu
mesh_terms: D019342:Acetic Acid; D000328:Adult; D003151:Community Health Centers / Q000706:statistics & numerical data*; D017679:Cryotherapy / Q000706:statistics & numerical data*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007202:Indicators and Reagents; D007214:Indonesia; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010865:Pilot Projects; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014932:Women's Health Services / Q000706:statistics & numerical data*
chemical_list: D007202:Indicators and Reagents; D019342:Acetic Acid