By Iffat Ara Sharmeen,
21
August, 2026
Women
in marginalised communities are disproportionately affected by climate change,
an additional barrier to the obstacles they already face in accessing proper
healthcare and treatment. Increases in soil and water salinity in these areas have been linked with
reproductive issues, including cervical cancer risks. An additional challenge
in accessing cervical cancer screening and treatment was the social stigma and
shame associated with it in conservative, rural communities.
Long
distances, limited awareness, financial constraints, and delayed early detection
and screening are just some of the other geo-logistical and socioeconomic
issues. With that in mind, Friendship and the Female Cancer Foundation started
the Cervical Cancer Screening Project in the South (CCSPITS) initiative in
Shyamnagar, Satkhira.
During the project years, 3,006 women received screening services. Among them, 79 women were identified as VIA positive, while 64 women gave consent to receive thermal ablation treatment. © Dr. Mosamat Umma Kulsum/Friendship
How the Service Delivery Model Works
There were significant
gaps in cervical cancer screening and treatment in the South. Community clinics
only registered women and referred them for VIA (Visual Inspection with Acetic
acid) screening at the Upazila Health Complexes (UHCs). The UHCs have screening
facilities and limited treatment options, which meant pre-cancerous patients
were referred to tertiary government hospitals. However, given the travel and
financial issues, many women had no choice but to drop out. By taking portable medical
equipment closer to women and raising awareness, Friendship ensured increased
participation of women in cervical cancer screening, diminishing stigma, giving
access to affordable treatment, and a working referral system that took less
time towards treatment.
A mobile team comprising of two paramedics
and one Health Educator travelled from village to village in satellite camps
and Community Clinics to provide VIA screening and Clinical Breast Examination
(CBE) for women aged 30–60 years. The team worked closely with Friendship
Community Medics (FCM) and Community Health Care Providers (CHCP) of the
community clinics, who organised awareness sessions and encouraged eligible
women to attend screening in clinics.
The goal of this programme was to take screening, awareness, treatment and referral services to the hard-to-reach coastal women through Friendship’s robust three-tier healthcare system. © Dr. Mosamat Umma Kulsum/Friendship
Community Engagement is Key to Healthcare Access
The initiative supported active participation of women through community engagement. Awareness sessions were held not just for the patients, but also their husbands and in-laws who were often family decision-makers. The village-to-village screening sessions through satellite camps and community clinics encouraged women to get screened. Before each screening session, women were informed about cervical cancer, prevention, common symptoms, and the importance of early detection. They shared their concerns beforehand and explained some of their reasons behind hesitance. These conversations helped build trust, which then ensured continuity in care after screening and treatment. Satisfied with the services, these women then encouraged other women within their neighbourhoods to screen for cervical cancer. In this manner, access and coverage of the services significantly improved, allowing more women to attend VIA screening and pre-cancer treatment sessions, which was previously unattainable in these areas.
CCST services are delivered through community clinics, family welfare centres, and local NGOs in Shyamnagar, with support from Friendship’s three-tier healthcare system. These activities intentionally extended beyond Friendship’s direct intervention areas so that women can receive services at the nearest practical point of care. © Md. Awlad Hossain/Friendship
Challenges Remain
The project faced several operational challenges, from heavy rain to difficult travel, shorter winter daylight hours, and sudden schedule changes. 15 women refused screening and treatment, citing family and social issues. VIA-positive women received pink cards after screening, which they often lost. Friendship saved their medical information in their proprietary mHealth app so that registration, follow-ups, and information retrieval remained uninterrupted.
In coastal Bangladesh, where distance, climate and stigma can stand between a woman and the care she needs, bringing screening and treatment closer can make all the difference. The chance to detect cancer early, receive timely care, and protect a woman’s health earlier in life becomes a possibility. Friendship is working toward cervical cancer elimination and encouraging screening for early detection of a cancer that is preventable through zero-cost screening and strengthening communication with communities, government entities, and other stakeholders. No woman should die from a disease that is preventable through screening.
Friendship’s CCST journey shows that when healthcare meets women where they are and stays with them through screening, treatment and follow-up, barriers that once seemed insurmountable can give way to hope. © Dr. Mosamat Umma Kulsum/Friendship