scholarly journals Implementing a Fee-for-Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 73s-73s
Author(s):  
T.P. Muffih ◽  
C. Claudettea ◽  
F. Manjuha ◽  
G. DeGregoriob ◽  
S. Mangaa ◽  
...  
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Health Services ◽  
Women’S Health ◽  
Women's Health ◽  
Cervical Cancer Screening ◽  
Fee For Service ◽  
Clinical Breast ◽  
Tract Infections

Background: Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. Trained nurses provide fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment of reproductive tract infections (RTI) and refer for further tests and treatment indicated. Methods: We retrospectively reviewed and analyzed WHP medical records from women who presented for cervical cancer screening from 2007-2014. Results: In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment of RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. Conclusion: The WHP's experience using a cost-recovery model and offering multiple services in a single clinic rather than stand-alone cervical cancer screening may be a practical model to make cervical cancer screening services accessible, comprehensive and sustainable. Integrating other women's health services enabled women to address additional health care needs.

scholarly journals Perceived Discrimination Is Associated with Reduced Breast and Cervical Cancer Screening: The Study of Women's Health Across the Nation (SWAN)

2014 ◽  
Vol 23 (2) ◽  
pp. 138-145 ◽  
Author(s):  
Elizabeth A. Jacobs ◽  
Paul J. Rathouz ◽  
Kelly Karavolos ◽  
Susan A. Everson-Rose ◽  
Imke Janssen ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Women’S Health ◽  
Women's Health ◽  
Cervical Cancer Screening ◽  
Perceived Discrimination ◽  
Breast And Cervical Cancer

scholarly journals Multi-site community-engaged quality improvement to inform regional cervical cancer screening implementation and sustainment in rural Sénégal

2020 ◽  
Author(s):  
Elle De Jesus ◽  
Hamidou Thiam ◽  
Landing Sagna ◽  
Zola Collins ◽  
Nicole Danfakha ◽  
...  
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Quality Improvement ◽  
Cancer Screening ◽  
Health Services ◽  
Cervical Cancer Screening ◽  
Screening Program ◽  
Improvement Program ◽  
Cancer Screening Program ◽  
Cervical Cancer Screening Program

Abstract BackgroundThe improvement of quality at the primary health care level in low resource settings is key to addressing health equity challenges around the world. In 2014, a Sénégal-Peace Corps-University of Illinois at Chicago partnership began to study the impact of a community-engaged quality improvement program on health services and regional health system determinants to prevent cervical cancer, the leading cause of cancer deaths among women in Sénégal. The purpose of this paper is to describe how a multi-site participatory quality improvement (QI) approach can identify access barriers and provide contextualized programmatic recommendations to strengthen the cervical cancer screening program in the rural Kédougou region of Sénégal and inform higher-level program implementation and sustainment.Methods: We adapted a facility-level quality improvement process by involving community health committee representatives. Using a mixed methods case study approach, we collected data at nine demonstration sites in the Kédougou region from quality improvement program action plans, client surveys, health leader interviews, and service guidelines discussions at the regional level from January 2015 through June 2019. We calculated the demand and supply-side barriers and organized them into the Levesque Patient-Centered Access to Health Care Framework.ResultsDuring the study period, 27 quality improvement meetings took place. There was a total of 50 (14 unique) stated access barriers to cervical cancer prevention across all sites. The health service barriers were concentrated in approachability (5) and availability and accommodation (16), whereas the demand-side barriers were concentrated in the ability to perceive (14) and ability to seek care (3). Individual health facilities responded with increased community outreach among other interventions while regional programmatic recommendations led to strategic partnership initiatives such as social mobilization and peer-to-peer education activities. ConclusionsThe community-engaged QI process has meaningfully contributed to strategic planning of the implementation and sustainment of a cervical cancer screening program within the context of rural Kédougou, Sénégal. The iterative and patient-focused nature of QI has allowed health personnel to continually strengthen how they deliver their health services to meet the community’s needs while data aggregated from QI action plans across multiple sites has helped inform responsive health policies to ensure program sustainment. The parallel and iterative application of participatory capacity building and QI activities across multiple sites provides a useful approach for implementing sustainable cervical cancer programs.

scholarly journals Opportunistic Breast Cancer Education and Screening in Rural Honduras

2016 ◽  
Vol 2 (4) ◽  
pp. 174-180 ◽  
Author(s):  
Linda S. Kennedy ◽  
Suyapa A. Bejarano ◽  
Tracy L. Onega ◽  
Derek S. Stenquist ◽  
Mary D. Chamberlin
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Health Services ◽  
Women's Health ◽  
Cervical Cancer Screening ◽  
Cancer Education ◽  
Breast Cancer Education ◽  
Women’S Health Services

Purpose In Honduras, the breast cancer burden is high, and access to women’s health services is low. This project tested the connection of community-based breast cancer detection with clinical diagnosis and treatment in a tightly linked and quickly facilitated format. Methods The Norris Cotton Cancer Center at Dartmouth College partnered with the Honduran cancer hospital La Liga Contra el Cancer to expand a cervical cancer screening program, which included self-breast exam (SBE) education and clinical breast exams (CBEs), to assess patient attitudes about and uptake of breast cancer education and screening services. The cervical cancer screening event was held in Honduras in 2013; 476 women from 31 villages attended. Results Half of the women attending elected to receive a CBE; most had concerns about lactation. Clinicians referred 12 women with abnormal CBEs to La Liga Contra el Cancer for additional evaluation at no cost. All referred patients were compliant with the recommendation and received follow-up care. One abnormal follow-up mammogram/ultrasound result was negative on biopsy. One woman with an aggressive phyllodes tumor had a mastectomy within 60 days. Multimodal education about breast cancer screening maximized delivery of women’s health services in a low-tech rural setting. Conclusion The addition of opportunistic breast cancer education and screening to a cervical cancer screening event resulted in high uptake of services at low additional cost to program sponsors. Such novel strategies to maximize delivery of women’s health services in low-resource settings, where there is no access to mammography, may result in earlier detection of breast cancer. Close follow-up of positive results with referral to appropriate treatment is essential.

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