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Expanding the Single-Visit Approach for Cervical Cancer Prevention: Successes and Lessons From Burkina Faso

Ouedraogo Y., Furlane G., Fruhauf T. et al. Global Health: Science and Practice (2018) CC

Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns. Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity. Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy. Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions. Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system. more

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Christian Responses to Health and Development

German Institute for Medical Mission (2014) C2

In 1964 medical mission was challenged and called to define its distinctiveness and its special role in the context of that particular time. The consultation "Tuebingen I" clearly stated: "The Christian church has a specific task in the field of health and healing"1, and developed a conce... more

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Reclaim the Gains - The Case for Investing in the Global Financing Facility 2021–2025

Global Financing Facility (GFF) Global Financing Facility (GFF) (2021) CC

The GFF needs an additional US$2.5 billion from 2021 to 2025 to enable countries to protect health gains and accelerate progress toward the 2030 Goals. Of this amount, the GFF urgently needs to secure new pledges of US$1.2 billion by the end of 2021 to help its current 36 partner countries protect ... more

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Africa’s Health Financing in a New Era

Africa Centres for Disease Control and Prevention (Africa CDC) (2025) CC

Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure on Africa’s already fragile health systems as ODA ...is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health. In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to 213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance. more

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Ready to Use Therapeutic Food (RUFT) and the WHO Essential Medicines List

CMAM Forum (2018) CC

Severe Acute Malnutrition (SAM) is one of the greatest child survival challenges in the world today and reportedly affects more than 16.2 million children each year1. High impact, proven treatment interventions exist yet sadly approximately only 3.2 million children with SAM have access to treatme... more

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Ghana: WHO report on the global tobacco epidemic, 2017

World Health Organization (WHO) (2017) C_WHO

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Ghana 2014 Status Report for the National HIV and AIDS Response

Ghana AIDS Commission (2014) C1

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Ecuador - Country Indicators Medical Devices

World Health Organization WHO (2014) C_WHO

Fact Sheet Global Atlas of medical devices

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Prevalence and factors associated with prediabetes and diabetes mellitus in Kenya: results from a national survey

Mohamed, S.F.; Mwangi M., Mutua1 M.K., et al. BMC Public Health (2018) C1

Mohamed et al. BMC Public Health 2018, 18(Suppl 3):1215 https://doi.org/10.1186/s12889-018-6053-xpre-

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African Union Health Information Exchange Guidelines and Standards

Africa Center for Disease Control and Prevention (2023) CC

The application of digital health technology is growing at a rapid rate in Africa, with the goals of improving the delivery of healthcare services and more effectively reaching out to remote and underserved communities. The lack of enabling guidelines and standards across the continent, on the other... more

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Best practices for including persons with disabilities in all aspects of developmennt efforts
recommended

United Nations (2011) C2

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Assessing the impact of Covid-19 on older people in the African Region

World Health Organization WHO, Regional Office of Africa (2022) C_WHO

A study conducted by the World Health Organisation Regional Office for Africa. The COVID-19 pandemic has had a significant impact on older persons both globally and in the African region. Although overall the region’s population is younger relative to many other world regions, the WHO AFRO region ... more

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Examining trends in family planning among harder-to-reach women in Senegal 1992–2014

Cavallaro F. L., L. Benova, D. Macleod et. al. Scientific reports (2017) C2

Recent increases in family planning (FP) use have been reported among women of reproductive age in union (WRAU) in Senegal. However, trends have not been monitored among harder-to-reach groups (including adolescents, unmarried and rural poor women), key to understanding whether FP progress is equita... more

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Preventing Malaria during Pregnancy in Sub-Saharan Africa: Determinants of Effective IPTp Delivery

Florey, Lia Calverton, Maryland, USA: ICF International (2013) C2

DHS Analytical Studies No. 39

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Long Term Trajectories of Fertility and Contraceptive Use - DHS Analytical Studies 58

United States Agency for International Development (USAID) (2016) C1

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Levels and Trends in Maternal and Child Health Disparities by Wealth and Region in Eleven Countries with DHS Surveys

Shireen Assaf & Thomas Pullum ICF International Rockville, Maryland, USA (2016) C2

DHS Comparative Reports No. 42

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Coronavirus in Sub-Saharan Africa - How africans in 12 nations are responding to the COVID-19 outbreak

GeoPoll (2020) C2

The spread of COVID-19 poses a challenge for emerging markets such as those in Africa and Latin America. While governments around the world are suffering from a shortage of ventilators, hospital beds, and personal protective equipment, availability of these items is already extremely limited in some... more

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HIV Fact Sheet 2014

Ghana AIDS Commission (2014) C1

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Low birthweight: country, regional and global estimates

World Health Organization WHO, UNICEF (2021) C_WHO

This report presents country, regional and global estimates of low birth weight for 2000, together with a detailed description of the methods used in calculating the estimates. Some limited data on trends are also included. The limitations of low-birth-weight data are described and recommendations a... more

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National Village Health Teams (VHT) Assessment in Uganda

Ministry of Health, Republic of Uganda (2015) C1

Best practices for including persons with disabilities in all aspects of developmennt efforts recommended

Best practices for including persons with disabilities in all aspects of developmennt efforts
recommended