The recent Women Deliver conference, held in Kigali last month, provided a dynamic platform for multifaceted dialogues encompassing women’s health, technological advancements in vaccine development, the pivotal role of community health workers, and the broader spectrum of Sexual and Reproductive Health and Rights (SRHR). Amidst the diverse discussions, a pivotal subject that resonated profoundly was the disconcerting prevalence of cervical cancer-related fatalities.
While the conference covered an array of topics ranging from cutting-edge medical breakthroughs to the empowerment of women, the distressing toll of cervical cancer held an indelible place in my reflections. Nations like the Philippines, Guatemala, and Burkina Faso confront the stark reality of cervical cancer claiming the lives of over 11 women daily, accumulating an annual toll surpassing 500, and unveiling 1130 new cases each year. These distressing statistics stand as poignant reminders of the imperative need for heightened education and awareness regarding the critical significance of early screening and effective treatment measures.
A case in point lies in Rwanda, where an estimated 3.7 million women aged 15–59, constituting approximately 30% of the total population in 2020, faced the risk of developing cervical cancer. Evidently, cervical cancer ranks as the most frequently diagnosed cancer among Rwandan women, boasting an alarming incidence rate of 42 cases per 100,000 women annually. To combat this formidable challenge, Rwanda pioneered a groundbreaking national program aimed at cervical cancer prevention through the vaccination against Human papillomavirus (HPV), becoming the inaugural African nation to do so. This visionary initiative, launched in 2011 targeting sixth-grade girls in primary schools, achieved an impressive 93% vaccination coverage within the target demographic (“Knowledge, Barriers and Motivators to Cervical Cancer: A Qualitative study” – led by Dr. Jean Pierre Gafaranga).
The theme of awareness resonates deeply, as my personal experience harks back to the year 2013 when the 2011 vaccination initiative extended to my boarding school. The perplexity surrounding these vaccines was palpable, with limited understanding pervading the community. This lack of awareness led some parents to harbor reservations and skepticism, fueling unfounded narratives and, tragically, leading to some withholding the vaccination for their children. While I count myself among the privileged who delved into the nuances of cervical cancer and HPV, the broader populace often lacks comprehensive knowledge. Surprisingly, a lesser-known fact is that HPV vaccination is pertinent not only to young girls but also extends to young boys. This glaring gap underscores the urgent necessity for expansive awareness campaigns to disseminate critical information about this insidious disease, ensuring that its risks and the indispensable nature of screening and vaccination are acknowledged by all before it’s too late.
Rwanda has introduced accessible and cost-effective methods for cervical cancer screening; however, the uptake of these screenings remains notably low. Delving into the heart of this issue reveals the existence of profound stigma, entwined with afflictions like HIV/AIDS, sexually transmitted diseases, menstrual disorders, and broader sexual reproductive health concerns. Such societal stigma becomes a formidable deterrent, obstructing women’s pursuit of adequate healthcare.
A compelling imperative surfaces when addressing cervical cancer within the context of women living with HIV. A study conducted by Gad et al. in 2021 scrutinized 298 Rwandan women who were HIV-positive, uncovering that 39.6% of them carried high-risk human papillomavirus (hrHPV), elevating their vulnerability to cervical cancer. Subsequent follow-ups revealed an alarming 6.7% surge in new cases with hrHPV. This alarming trajectory reinforces the notion that women living with HIV are at an elevated risk of hrHPV infection, consequently heightening their susceptibility to cervical cancer (“Twelve-Year Trend in the Prevalence of High-Risk Human Papillomavirus Infection Among Rwandan Women Living With HIV” by Gad Murenzi and others).
Undeniably, the presence of trained community health workers emerges as a linchpin in the crusade for health equity. The integration of educational resources into the training of these essential healthcare catalysts can potentially foster heightened awareness, rendering cervical cancer screenings more accessible. This augmented accessibility, in turn, could trigger increased rates of testing and early detection, particularly within rural enclaves.
The realm of gynecological visits remains a relatively uncharted territory for a significant percentage of women. A prevailing trend sees women seeking medical intervention primarily during pregnancy or upon marriage, with a disconcerting number reluctantly shying away from treatment altogether. This disinclination is intricately woven with societal stigma and a notable lack of confidence, manifesting as a barrier that obstructs timely diagnoses for conditions ranging from fibroids and cysts to cancer. Establishing a more robust rapport between patients and healthcare providers becomes instrumental in expediting early detection. Within this framework, the deployment of community health workers, adeptly educated about cervical cancer and related reproductive ailments, emerges as a potent remedy. The augmentation of awareness through educational materials coupled with the empowerment of these community health champions can pave the way for heightened inquisitiveness regarding women’s health. This, in turn, stands to amplify testing rates and facilitate early detection.
A pivotal juncture within the conference spotlighted cervical cancer screening and early intervention. The presentation underscored the transformative potential of self-sampling tools, empowering women to detect early indications and symptoms of cervical cancer autonomously. The inception of such tools has the capacity to redefine the testing landscape, accentuating early detection rates. It becomes increasingly apparent that fostering comprehensive awareness and comprehension of this condition is imperative.
The introduction of self-sampling tools in countries grappling with similar healthcare challenges, akin to Rwanda, stands as an impactful strategy to ease adoption and utilization. This concerted effort is fundamental to galvanizing health equity, signifying universal access to indispensable healthcare provisions and tools.
The trajectory toward elevated women’s health necessitates a collective commitment across sectors. Each endeavor, irrespective of size or scope, contributes substantially to this monumental movement. Technological integration and investment, in particular, forge novel pathways toward enhancing female reproductive health. The orchestration of a holistic health equity demands that every facet of society embraces its role in this transformative journey. Fundamental to this is the provision of requisite resources that culminate in a life of substance. Education, a cornerstone of women’s health and reproductive rights, widens the gateway for women to foster profound familiarity with their own bodies.
Encouraging open dialogue concerning sexual reproductive health and rights surfaces as a transformative avenue. Such discussions have the capacity to ameliorate education and awareness, paving the way for comprehensive understanding among women regarding the paramountcy of regular Pap smears in early detection. A poignant reflection by Dr. Eulade Rugengamanzi, an oncologist in training, accentuates that timely intervention can effectively treat cervical cancer, underlining the intrinsic value of ongoing self-education about the intricate changes our bodies can undergo, thereby nurturing holistic societal advancement.
As the global fight against cervical cancer gains momentum, it is imperative to channel greater research resources into enhancing detection methods and healthcare provisions for women, coupled with a resolute prioritization of routine consultations with gynecologists. The cornerstone in the global battle against cervical cancer remains rooted in early detection and treatment.
Sandrine Iradukunda adeptly amalgamates her affinity for technology, women’s healthcare, and artistic expression, embodying her roles as a screenwriter and voice-over artist. Through her narrative
craft, she kindles meaningful discussions centering on the intersection of health, technology, and holistic progress, thereby echoing a clarion call for transformative change.
