Queen’s University researcher Karen Yeates, a world leading expert in the use of mobile technology to improve health care in low resource settings, has received $500,000 in funding from Grand Challenges Canada to expand her cervical cancer screening program. Dr. Yeates works in Tanzania, one of the poorest countries in sub-Saharan Africa.

To ensure sustainability of the program, Dr. Yeates and her team have established a not-for-profit company called Wema Inc. It is funded by Grand Challenges Canada which, in turn, is funded by the Government of Canada.

Its Transition to Scale program brokers partnerships that mobilize private capital and domestic public resources to generate scalable and sustainable solutions that deliver measurable social impact.

“It’s been a really exciting process to take an idea and test it with success and then to be able to transition it to scale across a whole population,” says Dr. Yeates. “It will provide an incredible opportunity to save women’s lives in Tanzania and countries just like it where women have limited access to cervical cancer screening but have high disease rates. Tanzania and countries like it have relatively high numbers of women with HIV, so that is why using technology to overcome barriers and build a program like this is so important.”

An innovative approach to health

The funding will allow community-based health providers (typically nurses) to conduct cervical cancer screening with an innovative smartphone application called Servical. To perform a screening, the nurses apply acetic acid to a woman’s cervix and then inspect the cervix for specific features to determine if a woman has early signs of cancer. This method replaces the use of a Pap smear which is not available in most low income countries.

The caveat for performing visual inspection is that nurses require training and mentorship to do this well and correctly. Servical is an application that is downloaded to an inexpensive smartphone and allows the nurse to take a photo of the cervix to improve visualization and resolution above what the naked eye can do. Servical also has a built in function that captures and shares the image securely with more experienced expert reviewers (typically nurses and doctors in Tanzania) who then can provide instantaneous feedback through the app to teach the newly trained cervical cancer screening provider as to whether their diagnosis was correct or not and guides them to the correct treatment.

 This real-time supportive supervision is key to maintaining quality screening and sustainability of expanded cervical cancer screening programs because it significantly reduces the costs of supportive supervision. This will allow rapid scale up of cervical cancer screening programs in low resource settings.

“With our transition to scale funding in Tanzania we will work with international partners and the Ministry of Health to train as many cervical cancer screening providers at as many sites as possible across the country,” says Dr. Yeates. “Using the Servical app, will be able to rapidly increase the numbers of women receiving screening and same day treatment. We are also in discussions with these same international providers to launch the program in three to five other African countries and in Bangladesh.”