Integrating Cervical Cancer Screening Within Family Planning Service Provision in Peri-Urban Zambian Setting

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Cervical cancer is the leading cause of cancer-related deaths in developing countries. Second to breast cancer, it is the most common cancer in women worldwide and primarily affects women aged 30 years and older. In Zambia, cervical cancer (CACX) screening was introduced in 2006. Since then over 189, 000 women have been screened for CACX. While incidence and mortality rates of cervical cancer have fallen significantly in developed countries, 83% of all new cases that occur annually and 85% of all deaths from the disease occur in developing countries. Family planning (FP) services in Zambia have traditionally been offered routinely in maternal and child health (MCH) settings. The Society for Family Health (SFH) provides FP services using a dedicated provider model in high volume public sector health facilities since 2008. The model emphasises long-acting reversible contraception (LARC), while assuring method choice. Historically FP and CACX services have been offered in parallel. Previous integration of cervical cancer screening programs was mainly conducted within HIV programs because of the strong demonstrated association between CACX and HIV. An integrated FP-CACX program aims to efficiently reduce unmet need for critical sexual reproductive health services (SRH) services. We implemented an integrated FP and CACX service delivery model to determine the feasibility of integration and whether an integrated model would result in increased demand for both services by clients.