The first step of the screening process was a group or individual counseling session to explain the purpose and process of screening. A flipchart was used to assist in this process (see Appendix 2). During an individual counseling session, informed consent was obtained and pregnancy status was assessed. Syndromic assessment for sexually transmitted infections was part of the examination. For most of the project, women were screened primarily at health-center level by nurses using visual inspection with acetic acid (vinegar), known as VIA. VIA involves swabbing the cervix with 3 to 5 percent acetic acid, waiting at least one minute,.
