Implementation of the health directive for the prevention of cervical cancer at a primary care center in Huanuco

López L.; Reyes N.; Isidro M.; López A.; Puchuri M.; Antonio E.; Contreras J.; Fernández J.; Camarena I.; Tarazona I.; Torres G.; Aparco J.P. · Anales de la Facultad de Medicina (2026) · DOI: 10.15381/anales.v87i2.32776

Resumen

Introduction. Cervical cancer (CC) remains a public health challenge in Peru, with limited improvement despite existing interventions, likely due to implementation barriers. Objective. To assess the health and implementation outcomes of Ministerial Directive N°085 for CC prevention in a primary care center in the district of Chavinillo, Huánuco. Methods. An exploratory implementation study with a mixed-method approach was conducted between May and December 2023 in a high-altitude healthcare facility at 3,480 meters above sea level. The Consolidated Framework for Implementation Research (CFIR) was used to identify barriers and guide participatory planning, while the RE-AIM model was applied to evaluate outcomes. Results. HPV vaccination coverage reached 45% of schoolchildren aged 9-13 years identified through the nominal roll from educational institutions. For cervical screening among women aged 25-64 years, a nominal roll was developed across 15 rural settlements. A total of 350 women were located and agreed to participate; however, only 146 (41.7%) underwent Pap smear testing, all of whom received their results. Of the 27 women with abnormal cytology, four presented high-grade lesions, and one received diagnostic and treatment services at the previously equipped Chavinillo facility. Conclusion. These findings suggest that strengthening organizational and community capacities may be effective strategies to improve vaccination and screening coverage. However, ensuring sustainability will require not only guidelines and technology, but also sustained managerial commitment and leadership. © (2026), (Universidad Nacional Mayor de San Marcos, Facultad de Medicina). All right reserved.

Instituciones: Universidad Nacional Mayor de San Marcos