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Global Women\'s Health: Missed Preventive Screening Opportunities at a Rural Primary Care Clinic in Bolivia

Background: Studies have shown that a key determinant for receiving women’s health preventive services is a recent doctor’s visit. In low-income and resource-poor areas, physicians can effectively encourage screening by addressing preventive care during other medical visits. With lack of access to gynecologic care, a reminder may prompt primary care providers to offer preventive women’s health services. 


Methods: From 2005-2016, a chart review of 200 female patients ages 21 to 75 seen at the Yapacani clinic was completed.  Data was collected on the documentation of WHO and  ACOG recommended age-appropriate preventive women’s health screenings including: pap smears, STI screening, clinical breast exams (CBE) and mammograms.


Results: Out of 200 female patient charts reviewed, the percent of documented age-appropriate screening services were as follows: 32% pap smears, 10% mammograms, 4% STI testing, and 0% CBE. Ten percent of reproductive aged women who presented with a chief gynecologic complaint received STI screening.


Discussions: The chart review demonstrates a substantial number of missed opportunities for offering preventive women’s health services in this rural clinic. To address this gap, we created a women’s preventive care checklist  to be reviewed by the primary care provider with each presenting female regardless of chief complaint. We plan to track the changes in the percentage of women receiving recommended preventive care.


Keywords: Ambulatory Education, Community Health, Global Health, Rural Health, Underserved Communities

Topics: CREOG & APGO Annual Meeting, 2017, Resident, Faculty, Residency Director, Patient Care, Systems-Based Practice & Improvement, GME, CME, Quality & Safety, Public Health, Advocacy,

General Information

Resident,Faculty,Residency Director,
Patient Care,Systems-Based Practice & Improvement,
Quality & Safety,Public Health,Advocacy,
Clinical Focus

Author Information

Erin Cavanaugh, MD, Temple University; Stacey Jeronis, M.D.; James Day; Marisa Rose, MD

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