IPROC iproc Iproceedings 2369-6893 JMIR Publications Toronto, Canada v9i1e41571 10.2196/41571 Abstract Abstract Out of Adversity Comes Opportunity: Smart-Colpo National Program for the Elimination of Carcinoma Cervix in a Post–COVID-19 World Dinesen Birthe R Anjali MBBS, MS, DNB 1 https://orcid.org/0000-0002-7265-7189 Gowda Naveen R MBBS, DPM, MD 1
All India Institute of Medical Sciences Ansari nagar New Delhi, 110029 India 91 9663502239 drnaveen.nimhans@gmail.com
H Vikas MD 1 Prabhu Meghana DNB, DM 2 Sharma Jai Bhagwan MD, DNB, PhD 1 Vakharia Khyati MBBS 3 Kumar Atul MD 4 M V Akhila MS 5 Gatta Shilpa DGO, DNB 6 Sareddy Madhuri MS 7 K P Sowmya MD 8 T K Divya MD 9 Desai Devashish MD 1 Gopinath Bharath MD 1 Viswanath Somanath BE 10 Kini Ananth MD, DNB 11 All India Institute of Medical Sciences New Delhi India Institute of Liver and Biliary Sciences New Delhi India Vardhaman Mahavir Medical College and Safdarjung Hospital New Delhi India Employees’ State Insurance Corporation New Delhi India Gunasheela Fertility Center Bengaluru India SLG Hospitals Hyderabad India Gouri Devi Institute of Medical Sciences and Hospital Durgapur India Siddhartha Institute of Medical Sciences and Research Institute Bengaluru India Sapthagiri Institute of Medical Sciences and Research Institute Bengaluru India ATOS India Bengaluru India Military Hospital Kamptee, Armed Forces Medical Services Kamptee India Corresponding Author: Naveen R Gowda drnaveen.nimhans@gmail.com 2023 13 3 2023 9 e41571 31 7 2022 28 2 2023 ©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. 2023

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 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.

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