Adoption and Implementation of Affordable Cancer Technologies in El Salvador: Identifying Implementation Strategies for Successful Cervical Cancer Prevention in Resource-Limited Settings.

Abstract

As part of the affordable cancer technology program, our team developed and tested a portable thermal ablation (TA) cervical precancer treatment. This research helped support subsequent implementation of the technology in El Salvador. Here, we review successful implementation strategies deployed during the process and point to challenges and implications for other low- and middle-income countries (LMICs). We use the exploration, preparation, implementation, and sustainment framework to guide the discussion and identify associated implementation strategies used during each phase. Significant strategies were the development and maintenance of multi-actor partnerships and accessing new funding to introduce innovations to the country. In this case, planning for implementation began before the decision to adopt TA. The case of El Salvador highlights the need for such pragmatic approaches to shorten the time between scientific research and clinical practice in LMICs. The impact of these efforts has been significant: El Salvador has gone from one of the countries with the lowest cervical cancer screening rates in the region to one that can potentially meet elimination targets in the coming decades. This experience can serve as a blueprint for cervical cancer control efforts in other LMICs.