This paper is in the following e-collection/theme issue:

TTRN CPH 2022: "Digital Health beyond COVID-19: Lessons Learned" (37)

Published on in Vol 9 (2023)

Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/41571, first published .
Out of Adversity Comes Opportunity: Smart-Colpo National Program for the Elimination of Carcinoma Cervix in a Post–COVID-19 World

Out of Adversity Comes Opportunity: Smart-Colpo National Program for the Elimination of Carcinoma Cervix in a Post–COVID-19 World

Out of Adversity Comes Opportunity: Smart-Colpo National Program for the Elimination of Carcinoma Cervix in a Post–COVID-19 World

Authors of this article:

Anjali R1 Author Orcid Image ;   Naveen R Gowda1 ;   Vikas H1 ;   Meghana Prabhu2 ;   Jai Bhagwan Sharma1 ;   Khyati Vakharia3 ;   Atul Kumar4 ;   Akhila M V5 ;   Shilpa Gatta6 ;   Madhuri Sareddy7 ;   Sowmya K P8 ;   Divya T K9 ;   Devashish Desai1 ;   Bharath Gopinath1 ;   Somanath Viswanath10 ;   Ananth Kini11
Article Authors Cited by Tweetations Metrics

    Abstract

    1All India Institute of Medical Sciences, New Delhi, India

    2Institute of Liver and Biliary Sciences, New Delhi, India

    3Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

    4Employees’ State Insurance Corporation, New Delhi, India

    5Gunasheela Fertility Center, Bengaluru, India

    6SLG Hospitals, Hyderabad, India

    7Gouri Devi Institute of Medical Sciences and Hospital, Durgapur, India

    8Siddhartha Institute of Medical Sciences and Research Institute, Bengaluru, India

    9Sapthagiri Institute of Medical Sciences and Research Institute, Bengaluru, India

    10ATOS India, Bengaluru, India

    11Military Hospital Kamptee, Armed Forces Medical Services, Kamptee, India

    Corresponding Author:

    Naveen R Gowda, MBBS, DPM, MD

    All India Institute of Medical Sciences

    Ansari nagar

    New Delhi, 110029

    India

    Phone: 91 9663502239

    Email: drnaveen.nimhans@gmail.com


    Background: Carcinoma cervix is one of the leading causes of death among women worldwide. The World Health Organization has put forth the 90-70-90 global strategy for the elimination of cervical cancer as a public health problem. It calls for 70% women to be screened at least once in their lifetime. However, this rate is as low as 1.9% for India and even lower for many other countries, making the target insurmountable, especially in resource-constrained settings. The COVID-19 pandemic made this even more challenging.

    Objective: This study aimed to identify bottlenecks and high leverage points and propose a technology-driven, national-level program for improving the screening of carcinoma cervix.

    Methods: Detailed process mapping was done to identify potential bottlenecks. A counterfactual approach was used to identify high leverage points for impact using “What if” scenarios. These findings were used to build program theory–based logic models to propose a national-level program for carcinoma cervix prevention.

    Results: Availability, accessibility, affordability, skewed distribution of infrastructure, cost implications, and limited specialist workforce were identified as bottlenecks. The COVID-19 pandemic put a strain on existing resources and worsened the situation. The existing network of primary health care workers, changes in health-seeking behavior due to COVID-19 with the increasing role of tele-health, conducive political milieu with initiatives such as Digital India Mission, and a booming start-up ecosystem were identified as high leverage points through the counterfactual approach. Using these findings, a national program was designed with program theory–based logic modeling.

    Conclusions: The journey from <2% of women screened at least once in their lifetime all the way to 70% would need a drastic increase in funding and resource allocation, which is unlikely considering the current conditions. COVID-19 has not only been an adversity but also opened new thinking and opportunities. Artificial intelligence–driven, cost-effective, easy-to-use, and widely acceptable solutions such as “Smart-Colpo” can be a game changer to achieve the World Health Organization targets.

    Conflicts of Interest: None declared.

    iproc 2023;9:e41571

    doi:10.2196/41571

    Keywords

    Smart-Colpo; cervical cancer; screening; artificial intelligence; low-resource setting 

    Edited by B Dinesen; This is a non–peer-reviewed article. submitted 31.07.22; accepted 28.02.23; published 13.03.23

    Copyright

    ©Anjali R, Naveen R Gowda, Vikas H, Meghana Prabhu, Jai Bhagwan Sharma, Khyati Vakharia, Atul Kumar, Akhila M V, Shilpa Gatta, Madhuri Sareddy, Sowmya K P, Divya T K, Devashish Desai, Bharath Gopinath, Somanath Viswanath, Ananth Kini. Originally published in Iproceedings (https://www.iproc.org), 13.03.2023.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on https://www.iproc.org/, as well as this copyright and license information must be included.