Last October our partner FRIENDSHIP conducted a six-day training programme on cervical cancer screening for paramedics and doctors at the National Center for Cervical and Breast Cancer Screening and Training at the Bangabandhu Sheikh Mujib Medical University (BSMMU).
At PRESCRIP-TEC, we are improving coverage for secondary prevention of cervical cancer by conducting visual inspection with acetic acid (VIA). This is a well validated tool for use in low resource areas to identify precancerous lesions, and an effective method for reducing the incidence and the mortality of cervical cancer.
Friendship has been implementing a cervical cancer screening and treatment program in the Northern region of Bangladesh at two floating hospitals (EFH & LFH), two clinics at Gaibandha and Chilmari, and the Friendship Hospital Shaymnager in the South. They are using the standard protocol approved by BSMMU which includes VIA, colposcopy and cryotherapy.
Working on capacity-building in Bangladesh
Training and supervision of existing staff are an integral part of Friendship’s regular activities. The cervical screening and treatment training contributed to capacity-building through orientation on HPV and cervical cancer control. VIA, colposcopy, cryotherapy, thermal ablation, MIS integrated with District Health Information System Version-2 (DHIS2) were topics included in this training.
Training at BSMMU
The training on cervical cancer screening is aimed at service providers from different levels of health care. It was designed for capacity-building and rapid development of competence in detecting precancerous lesions by visual inspection with acetic acid (VIA).
Eight participants were selected to be part of this capacity-building event. The training was divided into four parts: theoretical, practical, evaluation and examination (pre- and post-testing). As part of the training each participant completed physical examinations on 5-6 patients every day under the supervision of the facilitator.
The participants were evaluated by the gynaecologist and the facilitator. After successful completion of the training, the appropriate authority provided certificates to all the trainees.
The service providers who earned the certificate will be supervised until they achieve a satisfactory level of competence. Friendship staff will be supporting service providers from BSMMU when they work at field level. Only certified providers who achieve a satisfactory level of competence will conduct screening tests in the field.
Objectives of the training
– Training service providers to perform the VIA method of cervical cancer screening for early detection of cervical cancer and precancerous conditions
– Helping to develop the referral linkage, follow-up, and management of VIA positive and CIN cases
– Developing participants’ knowledge about the anatomy, physiology, etiology, pathology, pathogenesis, management, histopathology, and counselling relevant to cervical cancer, precancerous lesions and breast cancer
– Facilitating data entry into DHIS2
– Developing participant’s skills in HPV swab collection and using the Liger thermal coagulator
Outcomes of the training on cervical cancer screening
– Early detection of cases and taking steps to prevent cancer in uneducated women who were previously ignored
– Provide primary treatment for cases which are detected early
– Promoting registration of women for cervical cancer screening in the community
– Community mobilisation to reduce the morbidity of women by creating awareness
– Strengthening supervision, monitoring, data collection and analysis
– Improving national level data entry at DGH-MIS, in all the centres including Friendship VIA centers in the North and the South
– Screening and treatment methodologies
– Frequency of screening
– Target age group for screening
– Operational aspects of program
– Mechanism of systematically inviting targeted women to ensure a high rate of participation
– Linkage between screening, diagnosis and treatment
– Program monitoring, supervision and quality assurance plan
– Record keeping, which must be up to the required standard (VIA, Colposcopy Register, cards, system for maintaining electronic database connected to DHIS2 of DGHS MIS)
This training was very useful, particularly in sharing information on HPV and the thermocoagulation technique. The information will also be disseminated at field level through various channels – online, at in-person training sessions and during meetings. Paramedics will share the information at monthly coordination meetings and internal training sessions to contribute to capacity-building and knowledge sharing.
Learn more about the PRESCRIP-TEC project