Imagine flipping through a comic book and you are introduced to a barista named Chris. Chris calls out to Ethel, a customer in his coffee shop, to collect her Jasmine Boba Tea order. He then gives Ethel some free advice, “Do you like swimming? I hope not,” he says, adding, “It's scary. What if a person in the pool has cervical cancer? The disease spreads through water. You will get infected!”
A neon yellow sticker jumps off the page with a big cross and a warning in bold letters, “That's wrong. Would you trust your sexual health to a barista?”
As you turn the page, you meet a confident, friendly community health worker (CHW) with a personality that reminds you of an endearing, positive character you’ve known for years. She says, “(It) should be me. A health worker. Because sexual issues are health issues!” She holds a register (record-keeping book) in her hand, with “Free service” written on it, and points to a health center.
This is no ordinary comic book. It serves as the primary communication tool for dispelling misconceptions and promoting positive health-seeking behaviors, such as cervical cancer screening. It was developed by Jhpiego in the Philippines under the Unitaid-funded and Expertise France-led Scale Up Cervical Cancer Elimination with Secondary prevention Strategy (SUCCESS) project. Jhpiego has led country implementation here since 2020 and is currently concluding a community-based self-sampling and treatment phase of the project.
But why a comic book? Especially for a topic as serious as cervical cancer—the third most common cancer among women in the Philippines, where twelve women lose their lives to it every day. Two of the most significant contributors to the Philippines’ staggering cervical cancer statistic are low screening rates and delayed treatment of HPV-positive women.
“Komiks, as we Filipinos call them, are one of the most popular forms of pop media,” said Donna Miranda, Project Officer for Jhpiego in the Philippines. “We have grown up reading them and can still easily rent or buy them at a local sari-sari store (a small neighborhood shop selling a variety of goods). So we aimed to create scenarios that dispel misconceptions around sexual and reproductive health using comic-style narratives as a hook, to engage people in these serious conversations.”
Using a familiar comic-style, the booklet includes two additional myth-busting scenarios similar to the one featuring the barista, Chris. In the subsequent pages, the friendly health worker explains, in simple language, what cervical cancer is, that it is caused by the Human Papillomavirus (HPV), where the cervix is located, how young girls can receive HPV vaccines, and the methods available for testing precancerous lesions among adult women, including self-sampling.
All topics are explained using simple, clear illustrations. The end of the booklet includes a screening and treatment card that women can use to keep track of their appointments.
“Aside from the women users, even health workers found the booklet innovative because the material is colorful and relatable,” said Donna.
The popularity of this comic-style communication inspired the SUCCESS team to adapt its visual elements into information, education, and communication materials, including posters and counseling flipcharts. They even featured an illustration of the uterus on an apron, worn by community health workers while counseling clients.
“The komiks intentionally use lay terms to make interactions feel more conversational. By removing formalities, power dynamics are less prevalent, and the relaxed tone helps the reader feel equal," said Rochelle Porras, a trained community health worker and convener for the Women Workers for Health Empowerment Network, a local partner to Jhpiego in the SUCCESS project.
An ardent advocate of women's health rights, Rochelle understands how to remove barriers for women in Quezon City and Metro Manila, making it less daunting for them to walk into cervical cancer screening sites. "Having cultural familiarity is advantageous because it makes it easier to connect with people and gain acceptance more readily,” she says. “The characters in the komiks are talking with each other, while the health worker is speaking to the reader, which makes it feel like you’re chatting with a friend.”
The interest generated by these komiks has sparked conversations about cervical cancer screening among women in the community. “CHWs also have our limitations,” said Rochelle. “We cannot reach everyone, but the best way is to have people echo what you taught them during the community health education and during the screening process with their neighbors and friends.”
An example of this is at a neighborhood football field, where the SUCCESS project has set up a makeshift counseling and screening site. As women begin arriving, they are greeted by a cardboard cutout featuring the same confident, familiar CHW from the komiks. In a message bubble above her head she’s saying, “Here, you can talk to an expert on reproductive and sexual health.” So far, close to 35,000 Filipino women have been screened for cervical cancer through HPV testing at 33 SUCCESS project sites across 11 regions in the Philippines.
The success of this komik-style communication has led the Philippines Department of Health to adapt this material for use across its national screening program.
Good health should be within reach for every woman, everywhere. It should be easy and convenient. “I hope that we reach the point where getting screened is something that we aspire to, without feeling anxious,” said Donna Miranda. “I hope it becomes as easy as going to a sari-sari store.”
Indrani Kashyap is the Associate Director, Regional Communications at Jhpiego and Jojana Christine General is an Advocacy and Awareness Officer for Jhpiego in the Philippines.
Tracey Shissler, SUCCESS/Jhpiego Program Director, reviewed this story.
