Page 0084

CANCER TRAINING AND EDUCATION

82 CANCER CONTROL 2015

teaching and mentoring; curriculum development for preservice

training; learning placements in the region or United

Kingdom; distance mentoring and coaching and e-learning;

and development of protocols, policies and systems at

department and institution level. They may emphasize

clinical, professional, leadership or other skills.

Partnership project objectives are based on an

institutional needs assessment, a shared vision, joint

ownership and a clear understanding of each other's

institutional structures and context. In-service training is

designed to fill observed skills gaps, and, while broadly

aligned with both national priorities and institutional needs,

partnerships are often strong advocates for areas of work

not prioritized by existing frameworks. For example, a health

partnership might work to address gaps in an existing course

or in cases where an institution may be unable to attract,

employ or pay the appropriate cadre needed to provide the

health services required by the population, the health

partnership works to upskill other health workers or lay

people (more positively expressed as task shifting).

Despite their diversity, health partnerships have certain

shared characteristics - peer-to-peer professional

relationships, a long-term perspective and an adaptable

nature - that enable them to achieve results that other

development interventions often find difficult.

Peer-to-peer relationships

Personal and professional relationships between health

workers are at the heart of health partnerships and are

crucial to their success and to the sustainability of what they

achieve. Whether it is doctor-to-doctor, midwife-to-midwife

or administrator-to-administrator, those working within

health partnerships have direct insight into the day-to-day

challenges faced by their counterparts and are in an

excellent position to tackle challenges and to work inside

existing systems for improved harmonization and alignment

of activities.

The most commonly cited changes reported by LMIC

partners are improved knowledge, skills and practice of staff.

Being involved in improvements to service delivery and

seeing the changes this resulted in, also bolsters staff morale

and confidence. Trainees frequently report that their

personal and professional development benefits at an

individual level, empowering them to challenge and change

practice.

Health-care professionals from the high-income partner

volunteer their technical expertise to act as advisers,

academic coordinators, mentors and trainers. During an

Continued

approach SVA). SVA avoids the woman having to return for

treatment. 1-2% of women screened might need to have

treatment with the thermocoagulator under local

anaesthetic which can successfully treat CIN (95% cure

rates). This is safe, effective, intervention and requires

minimal health professional training unlike other methods.

The planned pathway (Figure 3) involves community

screening of 1,000 women/camp over five days.

Approximately 50 women will screen positive and need a

colposcopy and 10-20 may require treatment which may

potentially prevent cervical cancer development.

What we have done so far? Over the last seven years we

have carried out hands-on colposcopy workshops, exchange

visits, nurse training, screening camps, training for

pathologists and biomedical scientists and quality

assurance. There are fully operational colposcopy clinics in

the hospitals we work with in Nepal.

Why is our partnership different to other similar

cervical cancer prevention projects? We provide a

"western" style model of care with: 1) effective treatment

with the thermocoagulator superior to cryotherapy

(freezing the cervix) used by other centres; 2) a focus on

colposcopy as an additional step in the pathway so to avoid

unnecessary treatment of women and 3) task-shifting

colposcopy roles from doctors to nurses.

What we value? 1) high quality training /education for

colposcopists, pathologists and laboratory staff; 2) quality

assurance and a focus on outcomes of the overall

programme and 3) research as integral part of project

development.

Challenges: The main challenge in cervical cancer

screening in any setting is to screen large populations with

an effective test and successfully treat pre-invasive disease

with minimal harm. In a low-resource setting this can be

challenging especially in Nepal which is largely rural.

Therefore the delivery of this strategy relies on

governmental support, committed teams and close working

between the all the stakeholders such as women's groups,

community leaders and screening groups.

www.phaseworldwide.org

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