Women-centered cervical cancer prevention in a low-resource setting: a case study of The Lily Project, Nicaragua.

Despite being preventable, cervical cancer is the fourth most common cancer among women worldwide. Barriers such as lack of quality care, social stigma, loss to follow-up, and limited knowledge of sexual health hinder access to cervical cancer screening and treatment, particularly among rural and low-income women. In this case study, we describe the Lily Project, a Nicaraguan-based cervical cancer prevention non-governmental organization working in a politically, socially and economically restrictive context. With no national HPV testing or vaccination program, and low quality, underfunded public health services, The Lily Project aimed to bolster cervical cancer screening and education for marginalized women in rural areas. Through multiple stakeholder collaboration, the organization implemented a women-centered approach that included mobile screening clinics and education to provide women with informed, private and female-conducted exams, results and follow up care. The Lily Project serves as a model of how women-centered care could be implemented in low-resource settings with particular attention to improving the quality of care for cervical exams for cervical cancer screenings among geographically and socially marginalized populations.