Trial reportGlobal health action2018
Comparison of patient flow and provider efficiency of two delivery strategies for HPV-based cervical cancer screening in Western Kenya: a time and motion study.
Trial report in Global health action, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed.
- The impact of text message reminders on cryotherapy uptake among women testing positive for HPV in western Kenya: a prospective cohort study.BMC women's health · 2024Trial
- Early experience scaling up a breast cancer early detection initiative integrated with cervical cancer screening in Rwanda.BMJ global health · 2025Article
- A prospective model of the potential clinical and economic impact of cervical cancer screening supported by a mobile phone app.PloS one · 2025Article
- Planning for resilience in screening operations using discrete event simulation modeling: example of HPV testing in Peru.Implementation science communications · 2022Article
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- HPV-based cervical cancer screening in low-resource settings: Maximizing the efficiency of community-based strategies in rural Kenya.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundImproving patient flow and reducing over-crowding can improve quality, promptness of care, and patient satisfaction. Given low utilization of preventive care in low-resource countries, improved patient flows are especially important in these settings.
objectiveCompare patient flow and provider efficiency between two cervical cancer screening strategies via self-collected human papillomavirus (HPV).
methodsWe collected time and motion data for patients screened for cervical cancer in 12 communities in rural Migori County, Kenya as part of a larger cluster randomized trial. Six communities were randomized to screening in community health campaigns (CHCs) and six to screening at government clinics. We quantified patient flow: duration spent on each active stage of screening and wait times, and the number of patients arriving at CHCs and clinics each hour of the day. In addition, for four CHCs, we collected time and motion data for providers, and measured provider efficiency as a ratio of active (service delivery) time to total time spent at the clinic.
resultsTotal duration of screening visits, at CHCs and clinics was 42 and 87 minutes, respectively (p < 0.001 for difference). Total active time lasted longer at CHCs, with a mean of 28 minutes per patient versus 15 minutes at clinics, largely due to differences in duration for group education (p < 0.001). Wait time for registration at clinics was 36 minutes, explaining most of the difference between settings, but sometimes incorporated other health services.
conclusionsThere is a substantial difference in patient flow at clinics compared to CHCs. Shorter duration at CHCs suggests that the model is favorable for patients in limiting time spent on screening. Future cervical cancer screening programs designed for scale-up should consider how this advantage may enhance satisfaction and uptake. For clinic-based screening programs, efforts could be made towards reducing registration wait times.
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