VIA (Visual Inspection With Acetic Acid) Service Goes to Public to Make Jakarta Free From Cervical Cancer

Background and context: According to GLOBOCAN data 2012, cervical cancer in Indonesia was in 2nd rank of cancer incidence for women in Indonesia. Aim: To raise public awareness toward cervical cancer and to increase the number of citizens who go through the early detection procedure of cervical cancer in Jakarta. Strategy/Tactics: In January 2017, Department of Health of Special Capital Region of Jakarta issued a new policy to increase the rate of cervical cancer screening in the city. The new policy includes: 1. A new reporting system in which all the patients who are subjected to cervical cancer screening to be recorded in a special form, so it can be well reported and traced. 2. The changes in the conventional way of cervical cancer screening in primary health centers into mobile service to make the medical staffs able to easily reach patients who live in peripheral areas in Jakarta. Program/Policy process: The enhancement of health education on cervical cancer and health promotion regarding the importance of cervical cancer screening using public transportation (Transjakarta bus), Papanicolaou test, and VIA test socialization in primary health centers. The results were obtained and assessed between January 2017-December 2017. Early detection rates were expected to increase by 50% compared with 2016. Outcomes: The results obtained include: 1. The new reporting system works as expected, tracing the patient with a positive VIA value becomes easier to monitor. 2. Medical teams are more active on introducing the early detection cervical cancer screening to society. 3. Various innovations were carried out, among others, by using public transportation, motorcycles to carry the medical tools and devices, a modified car that is equipped with mobile health services, and a house of citizens and the community hall that were turned into a place for examination. The number of people who have started to realize to do early detection after being educated with the knowledge of VIA test and cervical cancer is increased. The number of citizens who joined the cervical cancer early detection in 2016 was 48,960. After the policy and innovation was applied, the number increased into 105,060 citizens (increased by 114% from the previous year). What was learned: The increase of early detection rate of cervical cancer is quite significant from the previous year. For patients with positive result in their VIA test, cryotherapy was included as the part of treatment and follow-up. Costs incurred due to the treatment of cervical cancer can be reduced. With the result of this study, we can learn that there is an improvement in the quality of health services so that the number of deaths and morbidity from cervical cancer in Jakarta can be reduced.

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Scaling Up of Cervical Cancer Screening at Primary Health Care Level in Rwanda

Journal of Global Oncology ◽

10.1200/jgo.18.78700 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 54s-54s

Author(s):

U. Francois ◽

J.P. Balinda ◽

M. Hagenimana ◽

R. Samuel ◽

E. Arielle ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Screening Program ◽

Health Centers ◽

Care Level ◽

Primary Health ◽

Cancer Screening Program ◽

District Hospitals ◽

Cervical Cancer Screening Program

Background: Rwanda is a high cervical cancer-burden country, with an age standardized rate (ASR) of cervical cancer incidence of 41.8 cases per 100,000 people in 2012. In the same year, cervical cancer mortality lay at 26.2 deaths per 100,000 people. Aim: To address this burden, Rwanda initiated the vision inspection with acetic acid (VIA) screening-based strategy in 2013 in line with WHO recommendations for low- and middle-income countries. The target audience of the program was set for women between the ages of 30 and 49 and remains today. Here, we describe the implementation status of the program at the primary health care level; health centers and district hospitals in Rwanda. Methods: Integrating into Rwanda's existing health system, the program was purposefully rooted in health centers, with a pathway designed for women who screen positive to be referred to the district hospital for cryotherapy or LEEP, according to the lesions' size. Nurses, midwives and medical officers from health centers and district hospitals are trained through a 10-day curriculum (5 days for theory and 5 days for practice) before initiating the provision of services to clients in routine care. Monitoring of the program is conducted through both quarterly, on-site mentorship and screening indicators that are integrated into Rwanda's Health Management Information System (HMIS), through which facilities report on monthly basis. Results: Since its initiation in August 2013, Rwanda's cervical cancer screening program has been established in 21 of 38 (55%) district hospitals and 256 health centers in their catchment area. Training has been an integral component as well, with at least two nurses/midwives trained at implementing health centers and a medical officer with two nurses/midwives trained on cervical cancer screening and the treatment of precancerous lesions at district hospital. In addition, district hospitals have been equipped with cryotherapy, LEEP, and colposcopy machines. Over this program's implementation three-and-a-half-year course, 38,000 women have been screened for cervical cancer. Conclusion: Using a simple VIA-based strategy, Rwanda has been able to swiftly and effectively increase the number of health facilities implementing cervical cancer screening program. Though additional innovative implementation strategies are still needed to proportionally increase women's screening coverage, these initial steps hold great promise in Rwanda's ability to effectively implement a sustainable cervical cancer screening program.

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Cervical Cancer Screening Financing in Indonesia

Journal of Global Oncology ◽

10.1200/jgo.18.22700 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 93s-93s ◽

Cited By ~ 1

Author(s):

M. Wahidin

Keyword(s):

Primary Care ◽

Cervical Cancer ◽

Health Insurance ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

National Health Insurance ◽

Cervical Screening ◽

Health Centers ◽

Primary Health ◽

Care Facilities

Background: Indonesia has been developing social health insurance as attempt of universal health coverage with target of 100% population by 2019. The coverage was for all diseases from primary care until secondary care. Cervical cancer screening was among these which were covered by the insurance. In line with national program of cervical cancer screening, the insurance will strengthen the development of the program. As a new concept of financing - started in 2014- it need to know many circumstances of cervical cancer screening financing in Indonesia. Aim: The study was aimed to know overview of cervical cancer screening financing in Indonesia. Methods: Design of the study was descriptive study through literature review from related sources. Secondary data were collected from Directorate of Noncommunicable Disease Control and Center of Health Financing, Ministry of Health, and National Health Insurance Body (BPJS). The study was conducted in January- February 2018. Results: Cancer was ranked number 3 of highest claim for national health insurance with total IDR 1.54 trillion in 2014, became IDR 2.3 trillion in 2015. Number of cases of cancer, as claimed in hospitals, was also increasing from 702,207 cases in 2014 became 1,325,776 cases in 2015. Cervical cancer was among the highest claim. Based on Minister of Health Decree No. 52/2016 about tariff of healthcare in social health insurance, cervical cancer screening was covered by the insurance. Tariff of visual inspection with acetic acid (VIA) was maximum IDR 25,000 (USD 2), tariff of Papanicolaou test was maximum IDR 125,000 (USD 10), and tariff of cryotherapy of positive VIA was IDR 150,000 (USD 11.5). These tariffs can be claimed by providers of cervical screening in primary care facilities to BPJS through noncapitation scheme. This scheme was number of claim financing by BPJS to primary health centers according to type and number of health services. Mechanism of claiming was conducted by screening providers to financing officers in primary health centers using specific form to be sent to BPJS. Then, BPJS will process payment for accepted claim. Number of population became of BPJS in 2017 was 187.9 million out of 257 million target (73%). Meanwhile number of primary care facilities collaborated with BPJS was 20,708 (including 9813 primary health centers) out of 24,336 primary care facilities (84%). It means the financing of cervical screening could be used as optimal as possible to achieve national target of screening which was 37.4 million women aged 30-50 years. Conclusion: Cervical cancer screening financing was covered by national health insurance in Indonesia. Majority of primary care facility collaborated with BPJS which become strengthening factor to enhance achievement of national target of cervical screening.

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Systematic review of cervical cancer prevalence and determinants of early detection in Sub-Saharan Africa

KIBOGORA POLYTECHNIC SCIENTIFIC JOURNAL ◽

10.33618/kpscj.2018.01.006 ◽

2018 ◽

Vol 1 (1) ◽

pp. 32-36

Author(s):

Eleazar Ndabarora ◽

Dariya Mukamusoni ◽

Clarte Ndikumasabo ◽

Védaste Ngirinshuti

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Early Detection ◽

Cervical Cancer Screening ◽

Sub Saharan Africa ◽

Extensive Literature ◽

Early Management ◽

Screening Programs ◽

Mesh Terms ◽

Sub Saharan

Cervical cancer is one of the leading causes of morbidity and mortality globally and in Sub-Saharan Africa in particular. There is evidence that early detection and early management of cases are the best strategies to prevent and control this health threat, since treatment of the later stages of the diseases are very expensive. The objectives of the review were: (1) to identify and review studies on the prevalence of cervical cancer and determinants of early detection in Sub-Saharan Africa, and (2) to recommend further studies and interventions based on the findings of this review. Extensive literature search was conducted using the MeSH terms. Articles on cervical cancer and/or determinants of early detection which fulfilled inclusion criteria were reviewed independently by three reviewers. The prevalence of cervical cancer in Sub-Saharan Africa is increasing. Although there are evidences that cervical cancer screening programs are practical and feasible even in resource-limited settings in Sub-Saharan Africa, there is a very low uptake of cervical cancer screening and there are key factors that need to be addressed in order to make these programs established and effective.

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