In a quiet community where a water well doubles as a lifeline and a platform for change, Mbuya Chawenga, a community health worker in Tengwe district Mashonaland West in Zimbabwe, has been a beacon of hope. Using her yard as a water source and an awareness hub, she tirelessly educates women about cervical cancer screening. Amid the clinking of water containers, she shares life-saving knowledge, offering a private room for women to collect samples for HPV screening.
Tendai, a member of a religious group that discourages modern medical interventions—had long resisted these messages. Bound by her faith and fearful of judgment, she avoided health screenings. But one day, driven by a growing unease, Tendai cautiously approached Mbuya, swearing her to secrecy. Mbuya, understanding the delicate situation, guided her to the private room, ensuring her anonymity.
Mbuya Chawenga, a community health worker based at Tengwe Clinic, Mashonaland West, Zimbabwe
When the results came back, Tendai learned she was HPV positive. Overwhelmed and terrified, she was comforted by a direct and compassionate call from the community clinic nurse, who reassured her and encouraged her to take the next step for her health. After three weeks, Tendai mustered the courage to visit the clinic, where further tests revealed precancerous lesions.
Equipped with knowledge and supported by the nurse’s care, Tendai chose to undergo thermal ablation—a decisive action that marked a turning point in her life. By prioritizing her well-being over societal and religious pressures, Tendai safeguarded her health and also became a symbol of quiet bravery.
Transforming cervical cancer screening
CHAI, with support from Unitaid and the Judith Neilson Foundation, is working to transform cervical cancer screening through community-based HPV self-testing. We are collaborating with the ministries of health of Zimbabwe and five other countries: Kenya, Malawi, Nigeria, Rwanda, and Zambia, on this initiative. By delivering self-sampling kits directly to women in their homes and community health posts, this initiative aims to make screening more accessible and thus increase uptake. We are expecting the full results of this initiative in 2025, but preliminary findings are already promising, showing that community-based HPV testing achieves comparable rates of follow-up care to facility-based models. Women also report finding the self-collection process easy and convenient, reinforcing its potential to break down barriers to screening.
These approaches, including our work to develop a low-cost artificial intelligence based screening tool, highlight the power of innovation to empower women and bring life-saving healthcare closer to those who need it most. CHAI continues to support primary and secondary prevention of cervical cancer in some of the countries that face the highest burden of the disease, work that is critical to ensure a cervical cancer free future for women and their families.
Pivotal moment for the global cervical cancer elimination movement
The global cervical cancer elimination movement, now at its mid-point to 2030 to achieve the 90-70-90 targets set out by WHO in 2020, is at a pivotal moment. Effective tools like the HPV vaccine and HPV tests, including self-collection and thermal ablation devices, are revolutionizing cervical cancer prevention efforts. With growing national and global momentum, significant investments are needed to scale their use, strengthen health systems, and implement innovative single-visit screening approaches. Senior Ministry of Health officials from Rwanda, Nigeria, Zambia, and Zimbabwe echoed this urgent call to action during a CHAI-Unitaid strategic roundtable at UNGA 79, highlighting their shared commitment to eliminating cervical cancer.
Mbuya Chawenga’s tireless efforts to raise awareness have changed Tendai’s life and are steadily empowering entire communities, one conversation and one courageous decision at a time. By scaling the use of proven tools and models, fostering innovation, and empowering communities, we can work towards eliminating cervical cancer within our lifetime.
