“You Can Breast Health Club” Empowering Healthy Women of Myanmar to Enhance Breast Cancer Awareness and Take Action

Background and context: Pun Hlaing Siloam Hospital (PHSH), the only Joint Commission International (JCI) accredited hospital in Myanmar, is committed to provide comprehensive breast health services through “You Can Breast Health Club” in accordance with its vision; international quality, reach, scale and compassion. A free of charge membership-based club led by a dedicated medical oncology team that includes health care personnel, family members of breast cancer patients and healthy women of all walks of life. Aim: To promote awareness and take action on breast health and breast cancer so as to empower women to commit to lifelong breast health. Strategy/Tactics: The club executed its strategy through three pillars: 1) hospital-based comprehensive breast cancer care services, 2) community-based breast cancer education programs and 3) partnership with local and international organizations. The theme is “You can prevent the preventable; you can check for early detection; you can survive with effective treatment” with an aim to encourage women to play an active role in their own health. Program/Policy process: As part of a comprehensive approach to breast health, “one stop” hospital-based program provides breast health education on basic breast health and breast cancer facts, teaching breast self-exam, personal risk assessment and advise on risk reduction and to make healthy life choices. Interdisciplinary breast clinic provides clinical breast exam, state-of-the art breast imaging, diagnostic evaluation, referral for surgical and treatment options and patient family education. A training-of-trainers workshop on breast health was conducted for the hospital staff to facilitate program participants in turn to educate other club members and women in the local community. The club was launched in October Breast Cancer Awareness Month campaign held in October 2017 at PHSH. As a strategic partnership supported Shwe Yaung Hnin Si Cancer Foundation to host the World Cancer Day 2018 Community Cancer Awareness campaign held in Yangon. Outcomes: The number of club members increased to (282) within five months. Among the members, (204) women are from the community including family members of breast cancer patients, office staff, industry workers, and housewives reflecting the various socioeconomic status. The outcome was encouraging given that 60% of members are below the age of 40. What was learned: Community outreach breast cancer education programs combined with access to hospital-based services at affordable prices enhanced interest in club membership. The hospital-based strategy readily provides healthy women the facilities for early diagnosis and prompt access to quality care without any delays. Partnership with other advocacy groups accelerated the club process.

Summary Report of a Successful Policy/Advocacy Campaign by Breast Care International in Ghana

Background and context: Breast cancer is rapidly becoming a growing public health problem in sub-Saharan Africa and has the highest mortality among women. Research has demonstrated that African women are diagnosed with breast cancer 10 to 15 years earlier than their counterparts in higher-income countries. According to GLOBOCAN, in 2012 it was estimated that 2260 women are diagnosed with breast cancer and out of it 1102 died in Ghana. Breast cancer accounts for 15% of all malignancies in Ghana and it is estimated that majority of the cases are premenopausal and still in the work forces. Evidence has also shown that women who develop breast cancer at younger ages had more aggressive tumors, higher rate of metastasis, higher clinical stages and lower rate of hormone receptor expression (estrogen receptor and progesterone receptor) than older women. Aim: Provide education and screening on breast/cervical/prostate cancers and noncommunicable diseases (NCDs; hypertension and diabetes). Strategy/Tactics: Reach out to organized groups and offer them education and screening programs. Program/Policy process: We offered our policy/advocacy campaign by going outside the hospital to do public health education in the schools, offices, churches and communities especially in the rural areas where people don't have access to hospitals, on breast cancer education, early detection and screening. For the benefit of the people in the rural areas, this platform is also used to educate the people on NCDs such as hypertension, diabetes which is also killing a lot people due to lack of education. Outcomes: From the advocacy campaign on the breast cancer outside the hospitals we release that there has been much improvement in reporting breast cases to the hospitals early and a large number of people in the communities understand breast cancer and its implications. What was learned: If health workers and nongovernmental organizations involve themselves in breast cancer education and advocacy campaigns, it will help in eradicating and reducing the number of breast cancer cases in the country.