Chinhoyi - Meet Mary Mungwere. She is a Village Health Worker (VHW) in Ringari Village, Makonde District and attached to Umboe Clinic. 

When she received training for cervical cancer screening using HPV DNA testing in November 2023, Mary wasted no time in mobilizing her community through door-to-door interactions. Fast forward to today, Mary's efforts have resulted in 75 women being screened in her community alone, contributing to over 30,000 tests conducted in Mashonaland West Province.

"We were trained in November, and only two VHWs received that training from this area," said Anna. "After that, we started mobilizing communities, and I service beyond five villages and now, some of those not yet tested come to my house looking for screening services."

One such beneficiary, 42-year-old Maroro Nyumbwe, shares her story.

"I did the test, and after two weeks, I was called to the clinic to collect my results. They were positive, and further tests were done to confirm my diagnosis. Although it was tough news, I am grateful for the early detection."

Umboe Clinic, nestled within the hard-to-reach part of Makonde, Mashonaland West Province, is one of 22 primary level facilities providing cervical cancer screening closer to and within communities. The clinic is one of the facilities chosen for a pilot programme which commenced in 2023 and aimed to enhance screen services in rural areas.

“Working with VHWs we have trained them to collect samples to bring to the facility using integrated transport system, so we have decentralized services to village level,” said Dr Celestino Dhege Provincial Medical Director for Mashonaland West.

He added, “While the need to strengthen vaccination is imminent, we have to strengthen screening for women who are no longer eligible for HPV vaccination.”

Recently, the clinic hosted a team led by the Minister of Health Dr Douglas Mombeshora and a high-level delegation from the World Health Organization (WHO) Headquarters, including the Director for Non-Communicable Diseases (NCDs), Dr. Bente Mikkelsen. Their visit, which was part of a three-country mission aimed to assess the country's progress in cervical cancer elimination and explore avenues for collaboration.

Cervical cancer remains a significant public health concern in Zimbabwe, ranking fourth globally and regionally, with alarming incidence and mortality rates. Annually, approximately 3,043 women in Zimbabwe are diagnosed with cervical cancer, and tragically, 1,976 lives are lost to the disease. While Zimbabwe has established screening programmes, access remains uneven. As of 2019, only 20% of the population had access to screening services, with urban areas exhibiting alarmingly low rates of 3% and rural areas slightly higher rates at 10%.

"While we have made significant progress in eliminating our efforts, access to these essential services remains uneven across Zimbabwe," said Dr. Mombeshora. "Women in rural areas, and even more in urban centers, continue to face challenges in obtaining screenings and other preventive measures."

Despite this, Zimbabwe has made commendable strides in its response to cervical cancer. In 2018, the country introduced an HPV vaccination program with an impressive coverage rate of 89.7% in its inaugural year. To improve screening services, Zimbabwe now has over 200 sites conducting Visual Inspection with Acetic Acid (VIAC) and 60 sites performing HPV tests, facilitating early detection and prompt intervention. The recent programme where VHWs are engaged to provide screening will also enhance capacity and expand access to these services. Additionally, efforts to raise awareness and improve access to screening and treatment services are ongoing.

The visit by the WHO HQ NCDs team marks a pivotal moment in Zimbabwe's fight against cervical cancer. Collaboration with international partners and advocating for access to pledged funds present opportunities to scale up interventions and expand access to life-saving services. A comprehensive, costed plan will provide a roadmap for targeted interventions, ensuring efficient allocation of resources and sustained momentum in the fight against this devastating disease.

"Eliminating cervical cancer in Zimbabwe requires a multi-pronged approach," noted Dr. Mikkelsen, "with a focus on scaling up screening, vaccination programs, and public awareness campaigns. To achieve this, we need to build a strong case and secure the commitment of all stakeholders for a clear path forward."

In 2018, WHO adopted a global strategy to eliminate cervical cancer. This ambitious plan aims to achieve several key goals by 2030: vaccinating 90% of girls by age 15, ensuring 70% of women receive high-performance screening tests at 35 and 45 years old, and treating 90% of women diagnosed with precancer or cervical disease. Additionally, 90% of women with invasive cancer will receive management by 2030. WHO is actively supporting Zimbabwe with technical expertise to help the country reach these critical targets.