The incidence of invasive cervical cancer in Mexico is believed to be among the highest in the world even though a national screening program has been in effect for over 30 years. As the Mexican government struggles to overcome obstacles in delivering cancer screening services, civil society groups are working towards increasing the acceptability and accessibility of Pap exams among marginal populations. This paper examines a community-based program initiated by the Morelos Women’s Center (CMM), which trains traditional midwives to conduct Pap exams in rural communities. The study considers how the CMM seeks to address the cultural and structural obstacles that women face in public clinics as the national government retracts health services under neoliberal reforms. Drawing attention to the disjunctures that emerge as traditional midwives with little formal education are trained to carry out a biomedical program, the paper raises questions regarding how effectively community organizations can fill in the gaps left by a declining health system. The case suggests that micro-analyses of community health efforts are essential for identifying the potentials and limitations of civil society organizations as they increasingly take on responsibilities in health care planning, promotion, and distribution.

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