Task-shifting for point-of-care cervical cancer prevention in low- and middle-income countries: a case study from Uganda

Frontiers in Public Health

Public Health

Judith Auma¹  Allan Ndawula²  Louise Ackers³  James Ackers-Johnson³  Maaike Seekles⁴  Veena Kaul⁵  Claire Horder⁶ 

[1] Hampshire Hospitals NHS Foundation Trust, Basingstoke, United Kingdom;Kataraka Health Centre, Knowledge for Change (K4C), Fort Portal, Uganda;Knowledge for Change, University of Salford, Salford, United Kingdom;Liverpool School of Tropical Medicine, Liverpool, United Kingdom;Mid Yorkshire Hospitals NHS Trust, Wakefield, United Kingdom;School of Health and Society, University of Salford, Salford, United Kingdom;

关键词: cervical cancer;    prevention;    task-shifting;    frugal innovation;    geographic information systems;    results based finance;   

DOI  :  10.3389/fpubh.2023.1105559

 received in 2022-11-22, accepted in 2023-06-28,  发布年份 2023

来源: Frontiers

【 摘 要 】

Cervical cancer remains the leading cause of female cancer deaths in sub-Saharan Africa. This is despite cervical cancer being both preventable and curable if detected early and treated adequately. This paper reports on a series of action-research ‘cycles’ designed to progressively integrate a comprehensive, task-shifted, point-of-care, prevention program in a community-based public health facility in Uganda. The work has been undertaken through a UK-Ugandan Health Partnership coordinated by Knowledge for Change, a UK-registered Charity. The intervention demonstrates the effectiveness of task-shifting responsibility to Community Health Workers combined with the use of Geographic Information Systems to strategically guide health awareness-raising and the deployment of medical devices supporting respectful and sustainable point-of-care screen-and-treat services. The integration of this with public human immunodeficiency virus services demonstrates the ability to engage hard-to-reach ‘key populations’ at greatest risk of cervical cancer. The findings also demonstrate the impact of external influences including the Results Based Financing approach, adopted by many foreign Non-Governmental Organizations. The model presents opportunities for policy transfer to other areas of health promotion and prevention with important lessons for international Health partnership engagement. The paper concludes by outlining plans for a subsequent action-research cycle embracing and evaluating the potential of Artificial Intelligence to enhance service efficacy.

【 授权许可】

Unknown   
Copyright © 2023 Auma, Ndawula, Ackers-Johnson, Horder, Seekles, Kaul and Ackers.