Background and context: The estimate of new cases of breast cancer in Brazil in 2017 totaled 57,960 cases (INCA - National Cancer Institute). In addition to this estimate, we know that 75% of Brazilians are public health care users, which include patients fighting BC, who face several problems ranging from lack of early diagnosis to the lack of access to quick and appropriate treatments. BC is the deadliest neoplasia for women in the country, being responsible to approximately 18% of female deaths caused by cancer. Most of the time, patients are not provided with scientific information about the disease, health care systems, and applicable laws. Therefore, they do not take advantage of the opportunities to publicly fight for the cause and express themselves in an assertive way to assure and expand their rights. Thus, this project aims at training and educating these patients, so that they can become ambassadors of BC. Aim: Contribute to the training and education of BC patients and volunteers, encouraging the development of their leaderships and representation skills regarding the defense of Federação Brasileira de Instituições Filantrópicas de Apoio à Saúde da Mama’s (FEMAMA´s) cause. Strategy/Tactics: Organization of a pilot project in a given Brazilian state, aiming at training and educating at least 20 women on topics related to BC, advocacy and media training so they can become representatives of the cause. Program/Policy process: Planning: Preparation of a tool kit (folder with the contents of the training sessions, key messages and instructions on how to address the public) and training. Engagement: Engagement of BC patients and volunteers at NGOs so they can be trained. Implementation: Organization of a 40-hour training session on topics such as: causes and symptoms, diagnosis, treatments, principles and operations of private and public health care systems, on-site visits to public and private reference units in BC treatments, patient rights, advocacy, media training, etc. Feedback: searching opportunities for trained women to address the topics learned in lectures and interviews. Outcomes: 40 hours of training; 25 qualified ambassadors; a 25% increase in the number or correct answers in knowledge tests, when compared with pretests and posttests; holding lectures at companies and speeches at social control bodies by the ambassadors; two additional lectures for the continuing education of the ambassadors on biosimilar products and the assessment of health care technologies, after the end of the main training session; and approval of the project´s main sponsor to expand the project to 3 other Brazilian states. What was learned: There were no indications of breast cancer patients being treated in the public health care system to participate in the project, according to the hospitals themselves, as they did not want their patients to be empowered and give rise to demands that the hospitals could not meet. Therefore, we had to focus on our associate NGOs when searching for women to participate in the project.
Health Care System Planning for and Response to a Nuclear Detonation
