This guide outlines quality control (QC) and quality assurance (QA) considerations to support introduction or scale-up of visual inspection with acetic acid (VIA) as a screening test for cervical cancer, within the context of national comprehensive cervical cancer prevention and control programmes. The guide proposes a framework for QC and QA including a core set of indicators, and provides examples for how the indicators can be set, measured and used to strengthen programme implementation.
The guide is intended primarily for programme managers, supervisors and other stakeholders working in public health programmes for cervical cancer prevention and control. When using this guide, the following general considerations should be taken into account.
- This guide should be used as a supplement to the World Health Organization (WHO) Comprehensive cervical cancer control: a guide to essential practice (1).
- Visual screening methods include VIA and visual inspection with Lugol’s iodine (VILI). This guide will focus on QC and QA relating to VIA, given that VIA has been extensively evaluated through cross-sectional studies, prospective randomized trials and demonstration programmes, whereas the assessment of VILI is limited to a few cross-sectional studies.
- This guide also considers QC and QA related to cryotherapy, given the WHO recommendation to use this treatment modality in conjunction with VIA when possible. Therefore, this guide should be used together with WHO recommendations for the use of cryotherapy (2) and WHO’s technical specifications for cryosurgical equipment (3).
- The recommendations provided in this document are broadly applicable and may need to be
adapted to national policies, health systems, needs, languages and culture.