@article{fdi:010082431,
  title = {{I}mplementation of {HPV}-based screening in {B}urkina {F}aso : lessons learned from the {PARACAO} hybrid-effectiveness study},
  author = {{M}ensah, {K}. and {K}abor{\'e}, {C}. and {Z}eba, {S}. and {B}ouchon, {M}. and {D}uchesne, {V}. and {P}ourette, {D}olor{\`e}s and {B}eaudrap, {P}ierre de and {D}umont, {A}lexandre},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {C}ervical cancer screening in sub-{S}aharan countries relies on primary visual inspection with acetic acid ({VIA}). {P}rimary human papillomavirus ({HPV})-based screening is considered a promising alternative. {H}owever, the implementation and real-life efectiveness of this strategy at the primary-care level in limited-resource contexts remain under explored. {I}n {O}uagadougou, {B}urkina {F}aso, free {HPV}-based screening was implemented in 2019 in two primary healthcare centers. {W}e carried out a process and efectiveness evaluation of this intervention. {M}ethods: {E}fectiveness outcomes and implementation indicators were assessed through a cohort study of screened women, observations in participating centers, individual interviews with women and healthcare providers and monitoring reports. {E}fectiveness outcomes were screening completeness and women's satisfaction. {L}ogistic regression  models and concurrent qualitative analysis explored how implementation variability, acceptability by women and the context afected efectiveness outcomes. {R}esults: {A}fter a 3-month implementation period, of the 350 women included in the cohort, 94/100 completed the screening, although only 26/100 had their screening completed in a single visit as planned in the protocol. {T}he proportion of highly satisfed women was higher after result disclosure (95/100) than after sampling (65/100). {A} good understanding of the screening results and recommendations increased screening completeness and women's satisfaction, while  time to result disclosure decreased satisfaction. {A}daptations were made to ft healthcare workers' workload. {C}onclusion: {F}ree {HPV}-based screening was successfully integrated within primary care in {O}uagadougou, {B}urkina  {F}aso, leading to a high level of screening completeness despite the frequent use of multiple visits. {F}uture implementation in primary healthcare centers needs to improve counseling and reduce wait times at the various steps of the  screening sequence.},
  keywords = {{BURKINA} {FASO} ; {OUAGADOUGOU}},
  booktitle = {},
  journal = {{BMC} {W}omen's {H}ealth},
  volume = {21},
  numero = {},
  pages = {251 [16 ]},
  ISSN = {1472-6874},
  year = {2021},
  DOI = {10.1186/s12905-021-01392-4},
  URL = {https://www.documentation.ird.fr/hor/fdi:010082431},
}