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Background: HPV is associated with nearly all cases of cervical cancer. It is estimated that 15.8% of women in the Caribbean harbor HPV genotypes 16 or 18. Despite this fact, HPV vaccination is not currently a standard practice in the Dominican Republic. Cervical cancer remains the second leading cause of cancer mortality for women in the Dominican Republic (11.8%). Therefore cervical cancer screening is crucial to reduce mortality rates. The purpose of this project was to evaluate a cervical cancer screening program in the Sabana Grande de Boya region of the Dominican Republic administered by Medical Ministries International (MMI)
Methods: The Center for Disease Control’s (CDC) “Framework for Evaluation in Public Health” was used to evaluate the current MMI processes. Surveys administered to both patients (N = 33) and staff members (N = 5) and laboratory results from 2007-2015 (N = 683) were analyzed. Descriptive statistics of patient demographics, cytology results, HPV results, and follow-up care received were obtained. Frequencies of survey responses were grouped based on independent thematic analysis from two members of the research team.
Results: The majority of women screened were aged 21-30 (27.02%) and 14.93% had abnormal cytology results requiring follow-up. From 2012 to 2015 the percentage of patients positive for HPV was 26.37%. Staff and patients identified lack of education or knowledge (staff = 80%; patients = 30.3%) as a major barrier to reaching 100% of the women in the area. Telephone calls (18.2%) and outreach within the community (33.4%) were identified by patients as optimal ways to reach women in the community.
Conclusions: Recommendations included: (a) adoption of volunteer lay community health workers, (b) creation of an educational pamphlet, (c) development of a training protocol, (d) development of patient tracking database, and (e) planning for future ongoing program evaluation.