Speakers - 2026

Title: Implementation of the Kurigram project: A cervical cancer see-and-treat intervention in a rural district of Bangladesh

Abstract

Due to rurality and lack of health infrastructure, Kurigram, Bangladesh has less than optimal cervical cancer screening and treatment penetration. To address the public health needs of the district, interventions such as “See-and-Treat” mobile colposcopy, a single-visit method combining digital cervical inspection and treatment modalities such as thermocoagulation, have been proposed. One such project, the Kurigram Project, expanded See-and-Treat mobile colposcopy to more than 73,000 women aged 30-60 years, and has since become a self-sustained health initiative led by the Bangladesh Directorate General of Health Services. Our objective was to document key implementation strategies leading to efficient adoption and sustainability of the Kurigram Project to promote trial replication and scaling in other low- and middle-income countries (LMICs). 

We conducted a qualitative implementation study guided by the Expert Recommendations for Implementing Change (ERIC) framework to evaluate determinants of project success. We recruited clinical and administrative key informants across the following stakeholder groups: US-based clinicians, Bangladesh-based clinicians, community health workers, and funding partners. Semi-structured interviews were designed to document discrete implementation strategies. Data were analyzed using the Rapid Qualitative Analysis process. Overarching themes were mapped to the ERIC categories.

Thematic review of interview data mapped to 12 discrete implementation strategies. A key lesson learned is the need for deep community engagement, understanding of local cultural practices, and responsiveness to external factors that challenge preset protocols, such as epidemics or pandemics.

The results of this research emphasize best practices of the Kurigram Project in Bangladesh, such as recruitment of local community mobilizers (CM), utilization of existing governmental resources, and intervention tailored to cultural context. Despite minimal infrastructure to support cervical cancer care, Kurigram Project demonstrated long-standing success and serves as a proof of concept for those replicating trial design in other LMICs. Further applications of See-and-Treat cervical cancer model should consider strategies listed herein to overcome implementation challenges such as outreach, patient education, and health service delivery.

What will the audience take away from your presentation?

This study provides an overview of a highly successful see-and-treat cervical cancer screening model and a review of the relevant implementation strategies leading to its adoption and sustainability. Audience members will:

• Leave with an understanding of global health initiatives in LMIC to address cervical cancer.
• Expand knowledge on key strategies that encourages implementation success, relevant to replicating trials in other low resource settings.
• Describe practical solutions to common problems faced with cervical cancer screening and treatment, especially in the context of global health initiatives.
• Allow audience to consider barriers and facilitators of cervical cancer screening within own practice settings.