Pan African Medical Journal 2017;27:215. doi: 10.11604/pamj.2017.27.215.12994
It is estimated that more than 311 000 women die of cervical
cancer each year. Of these deaths, 91% occur in low- and
middle-income countries. De
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mographic changes and a lack of
action mean that the number of deaths per year is projected
to reach 460 000 by 2040.
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(Published with Decision No. 3003/QðBYT dated 19/8/2009 of the Minister of Health)
Background: Cervical cancer accounts for 23% of cancer incidence and 22% of
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cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso were limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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This report is one of the first major products of the newly established Precision Public Health Metrics unit of the UCN cluster of the WHO Regional Office for Africa. The report presents national trends in communicable and non-communicable disease b
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urden and control in the WHO African region. It tracks progress made with respect to disease burden reduction, elimination and eradication. It also highlights major emerging threats, opportunities and priorities in the fight against commu- nicable and non-communicable diseases in the region. It covers the period 2000-2022, but for some indicators, information is available only up to 2021.
The report shows the number of reported cases for malaria and vaccine preventable diseases (meningitis, measles, yellow fever, pertussis, diphtheria, tetanus, and polio); disease incidence due to HIV, tuberculosis and four major noncommunicable diseases (cardiovas- cular diseases, cancers, diabetes and chronic respira- tory diseases).
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The purpose of cancer screening tests is to detect pre-cancer or early-stage cancer in asymptomatic individuals so that timely diagnosis
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and early treatment can be offered, where this treatment can lead to better outcomes for some people.
The aim of a cancer screening programme is either to reduce mortality and morbidity in a population by early detection and early treatment of a cancer (for example, breast screening) or to reduce the incidence of a cancer by identifying and treating its precursors (such as cervical and colorectal screening).
This short guide is designed to be a quick reference that contains the important ideas about cancer screening. Readers should refer to other publications for comprehensive discussion and detailed guidance on cancer screening programmes.
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To identify and to assess factors enhancing or hindering the delivery of breast and cervical cancer
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screening services in Malawi with regard to accessibility, uptake, acceptability and effectiveness.
Systematic review of published scientific evidence. A search of six bibliographic databases and grey literature was executed to identify relevant studies conducted in Malawi in the English language, with no time or study design restrictions. Data extraction was conducted in Excel and evidence synthesis followed a thematic analysis approach to identify and compare emerging themes.
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The guidelines presented in this document are designed to provide a useful resource for healthcare professionals involved in clinical case management. They were developed taking into consideration services provided at different levels within the health system
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and resources available. These guidelines are intended to standardize care at both tertiary and secondary levels of service delivery across different socio economic stratifications of our society.
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This WHO Guidance Note advocates for a comprehensive approach to cervical cancer prevention and control
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and is aimed at senior policy makers and programme managers. It describes the need to deliver effective interventions across the female life course from childhood through to adulthood. These include community education, social mobilization, HPV vaccination, screening, treatment and palliative care. It outlines the complementary strategies for comprehensive cervical cancer prevention and control, and highlights collaboration across national health programmes (particularly immunization, reproductive health, cancer control and adolescent health), organizations and partners.
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Cervical cancer is the fourth most common cancer in women worldwide in 2018, with 570,000 new cases and
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311,000 deaths occurring annually.T he highest incidence rates are in Southern Africa, Eastern Africa, SubSaharan Africa, Western Africa, Melanesia, and Middle Africa . It also ranks as the leading cause of cancer-related death in most African countries. More than 85% of these deaths occur in low- and middle-income countries . In addition, women living with human immunodeficiency virus (HIV) are six times as likely to have cervical cancer
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HIV & AIDS Treatment in Practice No. 188
Version-1, June 2018
This document provides 3MDG stakeholders with essential information on SRHR indicators, derived from the 3MDG Logical Framework, Data Dictionary for Health Service Indicators (2014 June, DoPH, MoHA), A Guide to Monitoring and
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Evaluating Adolescent Reproductive Health Programs (MEASURE Evaluation, June 2000) and Monitoring National Cervical Cancer Prevention and Control Programmes (WHO, PAHO, 2013). Partners are strongly encouraged to integrate the SRHR indicators into their ongoing monitoring and evaluation (M&E) activities.
These indicators are designed to help partners assess the current state of their activities, their progress towards achieving their targets, and contribution towards the national response. This guideline is designed to improve the quality and consistency of data collected at the township level, which will enhance the accuracy of conclusions drawn when the data are aggregated.
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Cancer is an emerging public health problem in sub-Saharan Africa due to population growth, ageing and westernisation of lifestyles. In this piece, we use data from Mozambique over a 50-year period
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to illustrate cancer epidemiological trends in low-income and middle-income countries to hypothesise potential circumstances and factors that could explain changes in cancer burden and to discuss surveillance weaknesses and potential improvements. This epidemiological transition deserves increasing policy attention.
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This fact sheet is based on a systematic review of the literature on HPV and cervical cancer epidemiology,
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and a survey on policies and practices related to the prevention and control of cervical cancer among women living with HIV (WLHIV) to PAHO Member States. It details scorecards on the advances of countries against WHO recommendations and international commitments for cervical cancer prevention and control among WLHIV.
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Human Papilloma Virus (HPV) is the most common sexually transmitted infection, and two types of HPV (16 and 18) cause nearly 50% of high-grade cervical
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pre-cancers. HIV and cervical cancer are inextricably linked. Women living with HIV are six times more likely to develop cervical cancer, which is one of the AIDS-defining illnesses and the most common cancer among women living with HIV globally. Cervical cancer is a preventable, curable disease and can be eliminated as a public health problem with primary and secondary prevention, treatment, and care of cervical cancer, in combination with addressing social, health and other inequalities and integrated approaches.
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This summary covers the preventive approach to breast cancer control and includes prophylactic medications, prophylactic surgery and lifestyle modi
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fications for breast cancer prevention. Health professional training and individual risk assessments and counseling are also discussed.
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