PURPOSE: Cervical cancer disproportionately affects women in developing countries largely due to the absence of screening programs. Unless screening and treatment occur in one visit, loss to follow-up between visits reduces a program's effectiveness. This study was designed to examine the resources used in reestablishing contact with women who missed their scheduled visits and to assess the success of this effort in reducing loss to follow-up. METHOD(S): Women were enrolled in the screening study between 2000 and 2003 and all had scheduled 6, 12 or 24 months follow-up visits in 2003. The proportion of community health worker (CHW) time, vehicle use, maintenance, and depreciation spent reestablishing contact with women who had missed their appointments were estimated from weekly logs and cost accounting systems. The percentage of women who attended their scheduled visit, those who attended after CHW contact(s), and those who never returned despite CHW contact(s) were determined for each follow-up visit type. Number of CHW visits per woman by visit type was also estimated. RESULTS: 3,711 visits were scheduled in 2003. Of these, 2,321 (62.5%) occurred without CHW contact(s), 918 (24.8%) occurred after CHW contact(s), and 472 (12.7%) did not occur despite CHW contact(s). Loss to follow-up was reduced from 21% to 6%, 39% to 10%, and 50% to 24% for 6, 12, and 24 month visits respectively. CHWs attempted 3,200 contacts in 530 trips. On average, 3 CHWs attempted to contact 6 patients over each 111 minute trip. The per-patient cost (2003 Rand) for these activities was 12.75, 24.92, and 40.50 for 6, 12, and 24 month visits. CONCLUSIONS: CHW contact with women who missed scheduled visits greatly increased their return rate. With more time between visits, the success of this effort decreased and the per-patient costs increased. Programme costs such as these should be incorporated in cost-effectiveness analyses aimed at policy decisions about cervical cancer screening in developing countries.