October 08

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Cervical Cancer Prevention Program-Workshop

1st October, 2013 went for a Monitoring and Evaluation two day Training at Kabwe a Town 130km away from Lusaka. This was my first time to be away from the capital and was looking forward for the meeting to learn, meet new people see what they do and see the country side.

Kabwe is locally referred to as ‘Ghost Town’ for the fact that mining activities diminished, that meant less economic activities and pull out of investors.  The road infrastructure has been neglected. For almost two days I couldn’t access ATMs, to pay for my accommodation (no VISA machine at the hotel) being end month there were lots of queues with two Barclays and Stanbic ATMs out of order!!

On my last day to check out, I took time over lunch hour and queued for 30mins to access a local bank ATM and managed to pay the accommodation expenses. Patience and Resilience.

I take this opportunity to share my learning and document it.

The workshop was strengthening Cervical Cancer Prevention Program (CECAP).

This is a new program by jhpiego on mobilising, sensitising the communities especially women on Cervical Cancer Screening by VIA-Visual Inspection of Cervarix by Acetic Acid to highlight precancerous cells lesions)-this fundamentally makes the process a lot easier and shifts the identification of pre-cancer from Laboratory to the Clinic.

VIA can offer significant advantages over pap smear in low resource settings and where there is conscious efforts for increased screening coverage and good follow up. The method is seen to offer Cervical Cancer screening in more remote and less equipped healthcare systems. The results are immediate.

The target is to make it possible to screen and treat during same visit.

In many of the rural settings, there are economic and social challenges making it difficult for women to do return visits for follow up on treatment-hence ‘Screen and Treat’ approach on single visit.

Once screening results are out and patients are identified as VIA positive, assessment is done for their eligibility for Cryotherapy. Cryotherapy is basically application of extreme cold temperatures to treat identified cancerous lesions.

In advanced care clinics LEEP (Loop Electrosurgical Excision Procedure) is used. How I understood it, a wire loop heated by electric current to remove cells and tissues is used for diagnosis and treatment of abnormal/cancerous cells.

The community healthcare providers are trained to assess for referral complications and large lesions.

Coming from a Regulatory Affairs back ground, these were learnings. Simple innovative approaches to save people’s lives and improve on their well being.

What impressed the most was simplicity of the trainings with clear messages to exceed their targets by doing more sensitization and mobilization in screening and treatment at the community level.  The data should also be legible, reflective of the situation as assessed (credible) for it is used to make critical decisions among the stake holders-donors.

A two prong approach is also used when patients visit the clinic for cervical cancer screening and treatment. Also, HIV status is checked, newly diagnosed HIV Positive are referred for counselling and further review to start Anti-Retroviral Therapy (ART).  Those HIV Positive are evaluated if they are on ART therapy and adhere there is a further referral and follow up process.

See group photo after the workshop/training, in attendance jhpiego Staff (Mr. Webby and Dr. Joseph Banda) from Lusaka, Zambia, Danielle and John from jhpiego head quarters- Baltimore, USA, Giuliani from jhpiego office Tanzania and the community providers. Great team!!

Group Photo with jhpiego Team and providers in the field

Attending the training with participants

Attending the training session                                     Cancer Screening Map forms

Definitions

Monitoring-Routine tracking of priority information

Evaluation-Identifying changes over time and outcomes

Purposes of Monitoring and Evaluation

  1. Provide Stakeholders with information for advocacy
  2. Ensure accountability
  3. Evaluate progress towards established goals or targets
  4. Improve project implementation management and decision taking

Workshop Objectives

  • Review site experiences with data
  • Review current data collection management reporting and data use practises
  • Build capacity of the health providers to use data tools and data reach
  • Use consensus and standardize Data practices across providers and sites

Take home messages

  1. Community mobilization and sensitization for Cervical Cancer Screening taking a single visit approach.
  2. Provide reports in time
  3. Completeness and accuracy in data collection
  4. The program is a link to other services e.g. HIV status testing
  5. Appropriate data management (storage and labelling) and use
  6. Stock management of particulars and reagents useful at the clinics (appropriate storage and use to avert stock outs)

Early last month, there was an evening out door activity for patients living with cancer. Various organization and institutions were invited for an day long sports activity and evening walk around a football field until morning for those who could manage symbolizing sharing the agony and people living with cancer go through.  In attendance were jhpiego staff led by Country Director Mr. Kwame Asiedu.  Also in attendance were other dignitaries including Minister of Health. A representative from the US Embassy gave a speech that caught my attention. Zambia has the second largest number in world of reported Cervical Cancer cases. I asked myself how GlaxoSmithKline can partner with the government and/or like minded NGOs or institutions on this health concern e.g. introduce a vaccination programme against Cervical Cancer using such teams for sensitization and mobilization.

Part of the jhpiego team with T-shirts purchased at the venue to support patients living with cancer

jhpiego Team

JHPIEGO Country Director, Mr Kwame on the left and Zambia, Minister of Health in a track suit after hearty chat

In the back ground walking away is the representative from US Embassy

Health Minister and JHPIEGO Country Director

I have read the press release on GlaxoSmithKline and Barclays Bank partnership to increase access to healthcare and promote economic development in Zambia -its four key areas of partnership. This is a noble initiative to help access affordable healthcare which has been a challenge in many parts of Africa and is a global challenge.