Table 1 Specific objectives of each phase and corresponding activities

Phase 1 (year 1)—Understand the system

To evaluate the current status and challenges of existing cervical cancer screening services, capacity of health systems for transitioning to HPV-based screening, barriers faced by vulnerable women in accessing the cervical cancer care continuum and preferences with regards to HPV screening and treatment options

Desk review, health facility survey, qualitative studies, survival analysis of tribal women with cervical cancer vs others

Phase 2 (year 1)—Find leverage

To co-design acceptable HPV-based programmatic approaches for cervical screening and treatment, for vulnerable populations, based on the findings from the formative phase,

Co-design stakeholder workshop

Phase 3 (year 2)—Act strategically

To implement a cluster randomised implementation trial and evaluate implementation outcomes such as acceptability, reach and proportions well managed (screened and treated) of the HPV-based approaches, comparing to the existing VIA-based programme in India

Trial, supported by a screening registry

Phase 4 (year 3)—Learn and adapt

To determine the cost effectiveness, sustainability and scale up considerations of the preferred HPV implementation model

Final stakeholder workshop