Eric J. Suba ^1*, Sean K. Murphy ², Amber D. Donnelly ³, Lisa M. Furia ⁴, My Linh D. Huynh ⁵, Stephen S. Raab ⁶

¹ Kaiser Permanente
² The Valencepoint Group
³ University of Nebraska
⁴ University of California, San Francisco
⁵ Brigham and Women's Hospital
⁶ University of Pittsburgh

^* To whom correspondence should be addressed. E-mail: eric.suba{at}kp.org.

	Abstract

Papanicolaou screening is feasible anywhere that screening for cervical cancer, the leading cause of cancer-related death among women in developing countries, is appropriate. After documenting that the Vietnam War had contributed to the problem of cervical cancer in Vietnam, we participated in a grassroots effort to establish a nationwide cervical cancer prevention program in that country and performed root cause analyses of program deficiencies.

We found that real-world obstacles to successful cervical cancer prevention in developing countries involve people far more than technology and that such obstacles can be appropriately managed through a systems approach focused on programmatic quality rather than through ideological commitments to technology. A focus on quality satisfies public health goals, whereas a focus on technology is compatible with market forces.

Key Words: Cancer, Global Health, Access to Care, Quality of Care, Screening, Women's Health

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