The AWACAN-ED team in Zimbabwe is based at the University of Zimbabwe in the Faculty of Medicine and Health Sciences Clinical Trials Research Centre in Harare. The team of researchers has expertise in cervical cancer screening in low resource countries, gynaecological oncology, health systems research, and public health. They are passionate about reducing cancer related morbidity and mortality in sub-Saharan Africa through advancing earlier diagnosis of cancer in Africa.

Zimbabwe is divided into 10 administrative provinces, and the public health system has four tiers: primary, secondary, tertiary and quartenary. In the metropolitan provinces of Harare and Bulawayo there are no tertiary health care facilities, so patients with possible cancer symptoms are referred straight to quartenary hospitals. In the remaining eight provinces, patients with cancer symptoms are first seen in a primary health clinic (mainly by nurses) and then referred to a secondary and/or tertiary level facility (district/provincial hospital) for diagnostic procedures. Once a cancer diagnosis has been confirmed, patients are typically referred to the quartenary hospitals in Harare or Bulawayo for expert management depending on their geographical location.

For Workstream 1 and 3, in Harare we will recruit from Parirenyatwa and Sally Mugabe Hospitals (both quartenary facilities affiliated to the University of Zimbabwe’s Faculty of Medicine and Health Sciences) and two other hospitals, Marondera Provincial (tertiary facility) and Karanda Mission (secondary) Hospitals. We will also work with eight primary health clinics referring to the four hospitals.

In Bulawayo, we will recruit from Mpilo Central Hospital (a quartenary hospital affiliated to the National University of Science and Technology) which serves as the main referral centre for the Bulawayo Metropolitan Province and four other provinces in southwestern Zimbabwe. We will also recruit from Gwanda Provincial Hospital which is a tertiary care facility. In addition, we will work with four primary health clinics referring to the two hospitals.