OUTCOME OF CONDUCTING OUTREACHES IN CERVICAL CANCER SCREENING AT OL-JORO OROK SUB-COUNTY IN NYANDARUA COUNTY KENYA Lydiah Ndegwa, Danson Macharia, Osbon Kiptoo and Samuel Kabuthia

Background Cervical cancer continues to be a major cause of morbidity in women of reproductive age (WRA) with 500,000 cases reported worldwide. The incidence of cervical cancer is five times higher in people with HIV. Globally cancer of the cervix is the number two cause of cancers in women after cancer of breast and in the third world countries its ranked number one with prevalence of 25 per 100,000 WRA. In Ol-joro orok sub county outreaches were introduced in 2014 with 38 with confirmed suspicious cases out of 874 women screened (4.3%).

OBJECTIVE To increase the number of cancer of the cervix screenings in Ol-joro orok Sub County subsequently link and increase the follow up rates for cancer suspect cases for care and treatment.

METHODS Mobilization was done using daily health talks, posters, one - one by clinician at the consultation rooms and through going round with health wagon. Screening was done using visual methods during the outreaches. Clients with VIA/VILI positive were referred to the gynecologist and those with positive lesion were done cryotherapy. A support group was established for clients with confirmed lesions for continued education and support.

RESULTS 874WRA were screened, among whom 6 were HIV positive, 490 were negative, 378 were of unknown status and 1 had breast lump. 38(4.3%) VIA/VILI positive and 10 (1.1%) with positive lesion were referred to the gynecologist for cryotherapy and the rest were rescheduled.

OL-JORO OROK SUB COUNTY IN - REACHES YEAR 2014 FacilityDatesVia Villi total attendances Via Villi Number positive Number of Breast examinations Breast Lamps detected CervicitisNo. counseled for HIV No. tested for HIV No. positive for HIV No. referred Gatimu Gatimu Chamuka Chamuka Ol-bolosat Huho-ini Maina & Mwangi Silibwet Silibwet Kasuku Kasuku Totals

Health education before screening.

During mobilization.

CONCLUSIONS Routine screening enabled early intervention before progression of precancerous lesions hence reducing morbidity and mortality associated with cervical cancer. Cervical cancer screening using visual methods is therefore a cost effective method.

CHALLENGES 1.Elderly women declining screening due to age difference. 2.Fear of results associating cervical cancer with active sex life. 3.If screening were performed by male clinicians

RECOMMENDATIONS More health education especially to those declining screening. To be done routinely may be quarterly.

ACKNOWLEDGEMENT 1.APHIA PLUS KAMILI for their support during outreaches. 2.County and Sub County health management team. 3.Health staff who were present during outreaches.

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