The Well Women Clinic (WWC) is a special programme initiated by the Health Ministry to enable women to get themselves screened for common cancers and non-communicable diseases. These clinics are conducted by Medical Officers of Health (MOHs) and their staff. Women can walk in even without a prior appointment and obtain their service free. The Health Ministry recommends every woman to obtain the WWC service at the age of 35 and then, at 45.
Well women clinic
The concept of the well women clinic was generated with the concept of reproductive health. Following the International Conference on Population Development in 1994, the Health Ministry committed to improving local health services for women. Launching of the WWC programme was a remarkable consequence of that commitment. Existing health infrastructure was used to delivering the service.
A well-organised and effective MOH system is used for WWC. MOH staff were trained to perform services including Pap smear tests in WWCs. The target of the Health Ministry is to establish at least one WWC per 15,000 population and cover 80 percent of the target population. Now, WWCs are functioning in every MOH division.
Self-screening
The incidence of cancer is rising in Sri Lanka. Breast cancers and cervical cancers are the most common two cancers among women. But both the cancers can be easily identified at the early stage and can also be completely cured if detected early. In WWCs, women are screened for both cancers.
Cervical cancers are caused by Human Papilloma Virus (HPV). This cancer takes 15 to 20 years to develop as it is slow-growing. Therefore, every married woman is recommended to undergo a Pap smear test at the age of 35. That is the best time to detect early stages of cancer and it can be completely cured if detected at the early stage.
In addition to the above-mentioned cancers, thyroid examination has also been added recently to the package of services provided in WWCs. It helps to detect the early stage of thyroid cancers.
Other services
In addition to cancer screening, NCD screening is also done in WWCs. Awareness of menopause and providing necessary support to cope with menopausal symptoms is another service given.
Importance of screening
NCDs account for nearly 65 percent of deaths in Sri Lanka. Early detection and proper follow-up can minimise this percentage. Every woman who walks into a WWC is checked for blood pressure, blood sugar and body mass index. Then, appropriate referrals and advice is given to practise a healthy lifestyle.
Procedures
Breast examination is done by a trained female health worker in the clinic. That is a simple, but very important procedure. To detect cervical cancers, the Pap smear test is done. That is also a simple and non-painful procedure.
If a woman tests positive
If a screening test is positive, that woman is immediately referred for further investigations. In the case of breast cancer, the patient is referred to a specialist. Usually, mammography or ultrasound scan is performed, and if there is any suspicious growth, an FNAC or biopsy will be done to confirm the diagnosis. In both instances, tissue samples are taken and checked for cancer cells.
In the case of a positive Pap smear test, she will be referred to the nearest gynaecology and obstetrics unit for biopsy. After confirming the biopsy diagnosis, she will be referred to further specialist consultation. Complete surgical removal is possible at the early stage.
Open days
Anyone can easily obtain information by inquiring from the Area PHM (Public Health Midwife). Details are also displayed at the MOH office.
Special programmes
The Health Ministry conducts a felicitation programme for public health staff who perform well at the WWCs, each year. All MOHs who have reached 70 percent coverage of the target population are recognised.
In addition to WWC, outreach programmes are conducted. MOH teams conduct mobile WWC sessions during community health camps. MOH teams also visit government and private institutions to conduct mobile WWCs. This programme benefits working women who cannot find time to visit WWCs.
Some women are afraid of attending WWCs. Some women feel shy and some think that it is a painful procedure. It is not true. In a WWC, the Pap smear test is conducted by a nursing sister while ensuring the privacy of a person. Therefore, there is nothing to feel embarrassed. It is a procedure which does not cause significant discomfort or pain. Women are advised not to believe rumours.
Responsibility of community
All women are encouraged to get the WWC service at the age of 35 and then, at 45. It can be your mother, sister or spouse. If you really care about her, the best way you can show your care and concern is by taking her to a WWC.
In addition to the WWC, the Health Ministry launched another important initiative to prevent cervical cancers by providing the HPV vaccine to schoolgirls. Two doses of this vaccine are given at an interval of six months. Under the national programme, this is given to Grade 6 students. Usually this is given during school medical inspections.
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