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Caribbean
Cervical Cancer Prevention and Control Project
2002-2004
Update
Synopsis
of Major Achievements:
Completed
an assessment of cytology services in CAREC member countries.
This assessment was used to inform the development of a strategy
for improvement of cytology services in the region. link
Completed
a sub-regional situation analysis and, with input from the
project’s Technical Advisory Group and support from CAREC’s
Special Programme on Sexually Transmitted Infections (SPSTI),
drafted a Strategic Plan for Cervical Cancer Prevention and
Control in the Caribbean (2004-2007) that was endorsed by the
Caucus of Ministers Responsible for Health (2003) link
; In endorsing the Draft Strategic Plan for Cervical
Cancer Prevention and Control for the Caribbean, the Ministers of
Health committed to:
Ensuring
the necessary conditions for implementing well-organized,
national cervical cancer prevention and control programs, with
re-directed budgetary resources that ensure an integrated,
multi-sectoral approach to screening and follow-up of women in
the target group.
Eighteen
of the 21 CAREC member countries designated National
Programme Coordinators for Cervical Cancer Prevention and
Control. Sixteen (16) of the 18 National Programme Coordinators
were trained during a workshop held in May 2004. During the
training workshop Programme Coordinators were provided with the
tools necessary for planning, implementing and managing an
organized cervical cancer prevention and control programme in
their respective countries. link
Workshop
participants developed draft country plans and agreed on the
following milestones to be accomplished in their countries within
the next year:
Milestones
for Cervical Cancer Prevention and Control in the Caribbean
2004-2005
Year
1 work plan and budget for cervical cancer prevention and
control prepared –
OCT 2004
In-
country needs assessments of cervical cancer services completed
– DEC 2004
National
policy on cervical cancer prevention and control drafted–
DEC 2004
National
guidelines for screening and management of cervical cancer
finalized and implemented – DEC
2004
National
Strategic Plans for cervical cancer prevention and control
developed– APRIL 2005
National
Cervical Cancer Programme launched – MAY
2005
National
Cervical Cancer Prevention and Control Programme Coordinators
participate in the 2nd regional training workshop and
planning meeting and report on progress in implementing national
cervical cancer prevention and control programmes – JUNE
2005
Partnered
with CAREC’s EU-funded Strengthening of Medical Laboratory
Services in the Caribbean project to establish a Cytology
Advisory Group through which regional partners developed a plan
to strengthen cytology services, including a regional network
with reference nodes and an external proficiency system. This
advisory group represented pathologists, cytotechnologists,
public health practitioners and educators in related fields from
across the Caribbean and from Canada. The group developed
recommendations covering a wide array of issues that have
hampered development of cytology services in the Caribbean
including the following:
Competencies,
workload and job descriptions;
Reporting
and registration of smears;
Internal
and external quality assurance;
Establishment
of a regional cytology training programme Cytology
Advisory Group Report
To
address the immediate shortage of cytology professionals, CAREC
worked with, the French Technical Cooperation, the PAHO/WHO CPC
Office and the EU-funded Strengthening of Medical Laboratory
Services project to develop a proposal for French Regional
Cooperation funding training of 14 cytology professionals in
Martinique. This 3- month short-term training
course in Gynae-cytology which began on September 13 2004, is
currently in progress in Martinique with 14 trainees from 10
participating countries: Antigua & Barbuda, Belize, Dominica,
Grenada, Guyana, St. Kitts & Nevis, St. Lucia, St. Vincent
and the Grenadines. Suriname and Trinidad and Tobago. The
training is being done at the Pathology laboratory, University
Hospital, Fort de France, Martinique.
With
the support of CAREC’s EU funded Strengthening of Medical
Laboratories Project, cytology laboratories in 5 countries
(Belize, Dominica Guyana, St. Vincent and the Grenadines and
Trinidad and Tobago) have been assessed. This is with a view to
assisting to improve the quality of the services delivered in the
region as well as to facilitate the monitoring of the impact of
the newly trained cytology staff on service delivery.
To
support the development of a long-term training strategy for
cytology, CAREC assisted the Michener Institute for Applied
Health Sciences (Ontario, Canada) to submit a grant to CIDA to
support the development and implementation of a sustainable
training program in the Caribbean for cytology professionals, in
collaboration with a local tertiary institution. If successful,
the proposal will result in a competency-based cytology program
leading to a Bsc Degree in cytology. Information regarding the
outcome of this proposal will be forthcoming in November 2004.
Coordinated
a Communications Advisory Group and supported the PAHO/WHOCPC
Office and regional partners to develop a communications strategy
and advocacy materials for the regional Strategic Plan link.
The PAHO/WHO CPC Office developed a collection of stories
documenting experiences of Caribbean women attempting to prevent
and control cervical cancer. The booklet entitled, “She’s
My Sister” should prove extremely valuable as an advocacy
tool in support of the regional strategic plan. Other educational
materials on cervical cancer have been prepared by the CPC Office
Barbados and used to sensitize the media about the problem of
cervical cancer in the region at the recently held Caribbean
Media and Health Symposium in Antigua.
Support
was advocated for national and regional cervical cancer
initiatives at the 2003 annual meeting of Health Ministers for
the Organization of Eastern Caribbean States (OECS). As a
result, the OECS Secretariat was asked by the Ministers to
undertake a feasibility study of enhancing access to radiotherapy
treatment for OECS populations through shared services. The
results of this study were presented at the 2004 OECS Ministers
of Health Meeting.
National
Epidemiologists and Laboratory Directors have been sensitized to
the local cervical cancer situation and updated on the project.
In
collaboration with University of Heidelberg, Germany, four
surveys were conducted in Port-of-Spain Trinidad. One study
examined the views of physicians on cervical cancer screening and
management of abnormal Pap Smears. The second study assessed the
knowledge, attitudes and practices of men and women in relation
to cervical cancer screening in a multi-ethnic community using a
household survey. The third study assessed barriers to seeking
medical care after diagnosis of severe dysplasia or cervical
cancer and the fourth assessed barriers to participation in
cervical cancer screening in Trinidad and Tobago.
Convened 3
meetings of an active Technical Advisory Group which provides
guidance for the Project with representation from Ministries of
Health, PAHO/WHO (headquarters and field offices), the University
of the West Indies, national Cancer Societies, the Caribbean
Family Planning Affiliation, the Caribbean Association of Medical
Technologists (CASMET), and the specialties of pathology,
obstetrics and gynaecology, and family practice (Caribbean
College of Family Practitioners).
TAG
Report #1 , TAG
Report #2 ,
TAG Report
#3.
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