The proposed Prevention and Screening Innovation Project towards Elimination of Cervical Cancer (PRESCRIP-TEC) will lead to effective and innovative cervical cancer screening, including direct treatment and follow-up for women in resource-poor or hard-to-reach settings in the world, by improving availability, accessibility, acceptability and quality of services. PRESCRIP-TEC will conduct implementation research into cervical cancer screening and secondary prevention in different settings in four countries over three continents: Bangladesh and India in Asia, Uganda in Africa, and Slovakia in Eastern Europe. We will analyse patient- and health services-related facilitators and barriers for uptake of cervical cancer screening in low- and middle-income countries and in vulnerable groups in Eastern Europe. By taking existing screening protocols in the four countries, we will introduce 1) interactive information with communities via mobile devices and social media; 2) client-friendly, community-based strategies, with self-test for high risk HPV infection; and 3) artificial intelligence in gynaecological examination. The use of artificial intelligence built into mobile devices offers a future for high quality diagnostics in resource-poor settings. By doing so, we will reduce the number of physical examinations and implement screenings by lower-level trained cadres. In addition, through a cost-effectiveness analysis and a business case for the global introduction of hrHPV testing as routine screening for cervical cancer, we will show the advantage of point-of-delivery testing and the benefits of self-testing for cancer in the post-COVID era, which reduces pressure on the health system. PRESCRIP-TEC will strengthen evidence of innovative strategies for cervical cancer screening as advocated by the World Health Organization and will contribute to eradication of cervical cancer worldwide through prevention and early diagnosis, alleviating the global burden of cancer.

Health system barriers in vaccine uptake disproportionately affect specific ethnic, religious or cultural minorities across Europe and are therefore a major contributor to low vaccine uptake in these groups. RIVER-EU aims to identify and remove these barriers, specifically focusing on MMR and HPV vaccination in selected underserved communities (migrant community in Greece, Turkish females and Moroccan females in the Netherlands, Ukrainian minority in Poland and Roma community in Slovakia). First, we will analyze health system barriers and enablers to the vaccination of these communities, and then tailor existing interventions or develop new ones, which will be implemented and evaluated. Research findings will be translated in evidence-based guidelines and an educational platform for health care professionals that can be used to address equitable access to vaccination across Europe. We will use the Participatory Action Research approach to involve the target groups and key stakeholders, and to foster collaboration and knowledge co-creation among all stakeholders in every phase of the project. By building on existing research, findings and available information as well as on existing guidelines and recommendations, we will 1) increase understanding of the determinants of low vaccine uptake in specific contexts situated in the EU and/or Associated countries; 2) develop strategies to increase vaccination rates within these contexts; and 3) develop a series of recommendations that national and regional public health authorities could implement in order to increase vaccine coverage. Through the interdisciplinary approach and strong involvement of end-users and relevant stakeholders, we will maximize RIVER-EU’s impact by making sure the guidelines will be readily implementable, thus reducing health inequalities and improving access to vaccination services among underserved communities and increasing vaccine uptake and coverage in Europe.