Center for Health Market Innovations (CHMI)

Programs

PATH Cervical Cancer Prevention Program

last updated Sep 27, 2011

Overview

Implementing organization: 
PATH international in Vietnam
Implementation Partner(s): 
National Institute of Hygiene and Epidemiology, National Centre for Health Education and Communication, Provincial Obstetric and Gynecology Hospitals; Provincial Centres for Mother and Child Health
Legal Status: 
Private (not-for-profit)
Year Launched: 
2009
Stage: 
Existing/expansion stage

Funding

Primary Source of Funding: 
Donor
Additional Source(s) of Funding: 
In-kind contributions
Funders: 
Bill & Melinda Gates Foundation

Scale

Personnel Employed: 
50-99
Number of Clients Served: 
>45,000 people of VIA screening; >1000 referals
Number of Facilities Operated/Networked: 
17 Commune Health Stations; 2 district hospitals, 3 district preventive medical centres; 3 provincial hospitals, 3 centres of reproductive health services
Summary: 

PATH is working to ensure that women in the developing world have the tools and resources to protect themselves from human papillomavirus (HPV), which causes most cervical cancers. Instead of testing at district and provincial hospitals and waiting one week for the results, this initiative allows people to receive cervical cancer screening at Commune Health Stations and obtain their results in a matter of minutes.

Program goals/rationale: 

The “screen and treat” model using either HPV DNA testing or VIA (visual inspection with acetic acid) followed by treatment with cryotherapy (freezing) has been proposed by the Alliance for Cervical Cancer Prevention as the most efficient and effective strategy for secondary prevention of cervical cancer in low-resource settings.

Key program components: 

The initiative targets women ages 30 to 49 for VIA cervical cancer screening. This is the first time that screening cervical cancer can conducted at the grassroots level (commune health stations). Women who test positive at the commune health stations are treated with cryotherapy, if appropriate. When cryotherapy treatment is inappropriate, women are referred to the provincial or national level for loop electrosurgical excision procedure (LEEP) or another appropriate treatment.

The project also works to identify and adapt existing information, education, and communication materials and conducts activities to provide the community, especially women, with appropriate information on secondary prevention of cervical cancer.

The project's main activities are as follows:

(1) Strategic trainings to provide cervical cancer secondary prevention services.

  • Update course for national key obstetricians and gynecologists

  • Training courses for provincial, district doctors on visual inspection with acetic acid (VIA), cryotherapy and LEEP (loop electrosurgical excision procedure)

  • Training courses for provincial, district and commune nurses and midwives on visual inspection with acetic acid (VIA), cryotherapy

  • Provide equipment for health facilities to implement “screen – and – treat” model for cervical cancer.

(2) Develop a cervical cancer screening and early treatment service delivery model at that is effective at various levels of the health care system. The “screen - and - treat” model will be integrated into currently routine services at commune, district and provincial levels.

  • Monitoring and supervision activities will be conducted to assure the quality of services.

  • Final evaluation will be conducted by the end of the project to assess the effectiveness, feasibility and acceptability of the “screen - and - treat” model.

Program history: 

Under the newly updated National Standards for Reproductive Health launched in September 2010, the Ministry of Health has updated the technical guidelines for cervical cancer prevention. Meetings with national experts, policymakers, and key stakeholders were conducted to accelerate the development of effective guidelines that cover key issues, including screening techniques, diagnosis, treatment methods, and organization of screening and treatment based at different levels of the health system. The guidelines provide practical advice to health care providers at all levels of the health care system on how to prevent, detect, and treat cervical precancer. In particular, the guidelines ensure that health care providers at the primary and secondary levels possess the best available knowledge to deal with cervical cancer.

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