The CHILI consortium made significant progress toward its objectives, working closely with local partners and healthcare providers. In this reporting period, CHILI partners engaged with local Implementation Boards to discuss study plans and findings from formative research. This collaboration facilitated valuable input on the pilot study. Local experts highlighted the current strengths and weaknesses of cervical screening, providing feedback that informed study adaptations and ensured cultural and healthcare alignment.
A prospective cohort study was conducted among sexually active women in Ethiopia, Cambodia, Mozambique and Uganda, incorporating a nested Knowledge, Attitudes, and Practices (KAP) survey and a discrete choice experiment (DCE). The study aimed to estimate local cervical cancer screening coverage and assess women's knowledge of cervical cancer screening. To gain deeper insight into their needs, the DCE captured women’s preferences for specific cervical cancer screening services. Additionally, follow-up data was collected 3 months after the initial survey to evaluate the impact of cervical cancer information provision on screening uptake, enabling researchers to assess if survey participation and exposure to cervical cancer information influenced actual screening behavior and knowledge.
The CHILI team prioritized sample collection, gathering samples from women across four countries. Each participant provided both a self-collected sample and a provider-collected sample, including women with and without cervical lesions, and women living with HIV in the three African countries. Recruitment included women screened for the first time, whose cervical health status was initially unknown, and participants with prior abnormal VIA or Pap smear results, who were more likely to have cervical lesions. All samples were shipped to Belgium, where self-samples underwent HPV DNA analysis and provider-collected samples were used for cytology (Pap smear) analysis. These samples will validate the new screening device before its application in the implementing countries. Finally, the CHILI team advanced the screening tool.
