Background: Cervical cancer accounts for 23% of cancer incidence and 22% of 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 wer...e 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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Failure to Credibly Investigate and Provide Redress for Unlawful Attacks in Yemen
Trials (2018) 19:271 https://doi.org/10.1186/s13063-018-2604-9
Based on the findings of this trial, we will examine the potential use and scale up of iSupport for caregiver distress in India. This style of online self-help programs could be expanded to other regions or countries or to other suitabl...e caregiver groups
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Malaria Journal (2018) 17:460 https://doi.org/10.1186/s12936-018-2606-9
In malaria endemic countries, asymptomatic cases constitute an important reservoir of infections sustaining transmission. Estimating the burden of the asymptomatic population and identifying areas with elevated risk is import...ant for malaria control in Burkina Faso.
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In the framework of the United Nations Sustainable Development Goals Issue-based Coalition on Health and Well-being for All at All Ages in Europe and Central Asia
PLOS ONE | https://doi.org/10.1371/journal.pone.0203986 October 3, 2018
Zule et al. Harm Reduction Journal (2018) 15:44 https://doi.org/10.1186/s12954-018-0249-3
Compiled by Tin Geber for HIVOS. London, March 2018
The primary audience for the guideline is policy makers and health programme managers of MNCH and immunization programmes in ministries of health where decisions are made and policies created on the use and implementation of homebased records.
The guideline is also aimed at health providers who use... home-based records as a tool for recording information and providing health education or communicating key information. Development and international agencies and non-governmental organizations that support the implementation of home-based records will also find this guideline of use.
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Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoidable suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic p...alliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
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Human Resources for Health201816:49; https://doi.org/10.1186/s12960-018-0315-7
Integrated Management of Acute Malnutrition National Guidelines
Expert Consensus Report for Emergency Centres in
Western Cape
2018 Progress Report
PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020)
October 2018
This publication was produced at the request of the United States Agency for International Development. It was prepared independently by David Lowe, David Hales, Britt Herstad, Billy Pick, Aisuluu Bolotbaeva, and Gulgun Jonboboeva.