09/05/2025
Rethinking Cervical Cancer Screening in LMICs through A Human-Centered Design Thinking Approach
Cervical cancer is one of the starkest examples of global health inequity.
In 2022, it was the 4th most common cancer in women and the 4th leading cause of cancer death.
There were about 660,000 new cases and 350,000 deaths. Nearly 90% of these deaths were in low and middle-income countries (LMICs) where access to middle-income care is limited.
Despite years of investment and proven methods of prevention, many women in LMICs still avoid screening.
Working with the Health for Humanity Foundation, I have seen how a centuries-old medical instrument, the speculum, continues to stand in the way of life-saving as a barrier
Across both rural and urban clinics, studies examine what women often tell.
The speculum is painful, intimidating, and deeply uncomfortable.
In Moshi, Tanzania, a study of 354 women showed fear, pain, and vulnerability as the dominant reasons for avoiding the exam.
A UK review found older women were more likely to skip screening because vaginal atrophy or past trauma made the speculum exam unbearable.
In Michigan, a study among Black women ranked the speculum as the number one barrier.
When offered self-sampling, most women chose it instead.
This barrier does not stand alone. When combined with long waits, staff shortages, stigma, and a lack of privacy, it results in missed opportunities and too many late diagnoses, especially in LMICs.
Why this matters
In LMICs, the absence of safe and culturally acceptable screening fuels mortality.
This happens even while Human Papillomavirus (HPV) vaccines and affordable testing methods are available.
Health for Humanity Foundation made some key observations on the ground.
In our work, we meet women who refuse screening out of fear of pain.
We see clinics overwhelmed with too few exam rooms and too few staff.
Even educated women hesitate, telling us, “It feels invasive and dehumanizing.”
Behind these stories is a simple truth.
Screening must respect dignity, give women privacy, and remove unnecessary barriers.
A path forward
What if women could be screened without ever facing the speculum, while still receiving accurate results that tie seamlessly into existing health systems?
That vision drives our current design work at Health for Humanity.
We are exploring models that allow privacy, speed, and empowerment, while linking to digital workflows, lab processing, and navigator support.
Our goal is to normalize comfortable screening and, in the process, boost HPV vaccination, same-day treatment, and community-led health progress.
This is what we have noticed and practically observed:
1. Cervical cancer deaths: nearly 90% occur in LMICs
2. Studies in Tanzania and Michigan confirm speculum pain is the top barrier
3. Self-sampling has proven accuracy equal to clinician-collected samples
4. Older women are disproportionately excluded due to vaginal pain from speculum use
Multi-systems thinking in application
Our work is designed to integrate across layers of the health system:
1. Human-centered design that removes emotional and physical barriers
2. Public health strategy that combines HPV testing with vaccination drives
3. Digital platforms for SMS/text message follow-up and aggregated dashboard monitoring
4. Logistics and lab networks that ensure quick sample processing
5. Policy alignment with WHO guidelines and national health strategies
This is beyond chasing a single quick-fix. It is building a scalable, empathy-first model that respects women while strengthening health systems.
In the fight against cervical cancer, the speculum has become a relic that holds women back.
At Health for Humanity Foundation, we are working to build a future where screening is safe, dignified, and accessible.
With the right design, data, and systems working together, we can expand prevention, increase vaccination, and save lives.
(c) Bright Chimezie Irem
Health for Humanity Foundation.
