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Alliance for Cervical Cancer Prevention Small Grants Program

The Alliance Small Grants Program provided funding for 42 small grant projects in 1999-2004. As of August 2003, all funds were committed and no new proposals could be considered. The following is a summary of all projects funded under this program.

Albania

Albanian Family Planning Association (AFPA)

The Albania Family Planning Association’s small grant project focused on improving the status and capacity of reproductive health services in the Vlora District of Albania. Project activities included developing and publishing informative materials, preparing and broadcasting information programs on television, conducting workshops for health care providers, and providing Pap smear tests through the APFA’s Women’s Center. At the close of the project, AFPA had consulted with over 2,000 women on reproductive health issues, especially cervical cancer, and performed 805 Pap smears. AFPA facilitated 20 workshops with women and health centers. These workshops, attended by 528 people, aimed to raise awareness of cervical cancer risks and preventive measures. AFPA disseminated 2,000 brochures on cervical cancer prevention and reached around 50,000 people with the TV programs they created about cervical cancer risks and prevention. With the increase in community education, outreach, and awareness, AFPA recorded an increase in the demand for services through increased referrals of women for screenings by health care workers and an increase in their client numbers.

Albanian Family Planning Association (AFPA)

The Albanian Family Planning Association received a second small grant award to extend coverage of cervical screening among rural women over 30 years old in the Vlora district of Albania. Through educational workshops with both rural women and health workers, the dissemination of 1000 informational leaflets about cervical cancer and Pap tests, a television announcement, and free Pap testing, the AFPA has greatly improved women’s awareness of cervical cancer and prevention efforts. Their activities also have included informal meetings with abused and trafficked women in collaboration with the Shelter Center for Trafficked Women. The meetings provide an opportunity to introduce cervical cancer prevention to this population of women who are generally bypassed by health services.

Argentina

Centro de Estudios de Estado y Sociedad (CEDES)

With small grant funds, CEDES instituted a project to analyze current practices of health professionals and beliefs of the public concerning cervical cancer prevention, and subsequently develop strategies for improving prevention efforts through improved communication. Through focus groups and interviews, CEDES has evaluated the quality of care offered by health professionals, materials, technical capacity, and available training with respect to cervical cancer prevention in Buenos Aires. Using information gained through the interviews, CEDES plans on conducting workshops to improve communication skills for health professionals and women seeking services. Additionally, after interviewing women and analyzing public opinion and knowledge concerning cervical cancer and Pap testing, the project has trained health journalists on the basics of cervical cancer prevention through a one-day seminar.

CEDES

CEDES received additional small grant funding to study the quality of cervical cancer prevention services women were receiving in public hospitals in Buenos Aires. The study compared the quality of services at three different hospitals in Buenos Aires, two public hospitals and one private hospital, and looked into women’s knowledge of cervical cancer prevention services, experiences at their respective hospitals, and their overall satisfaction with the services they received. CEDES’s findings have been communicated to those in a position to effect service improvements within each hospital.

Fundación Medicina Familiar (FMF)

With their small grant award, FMF conducted an evaluation of the current cervical cancer prevention program in the public health system of Buenos Aires in order to identify barriers that affect women’s access to prevention services. Through focus groups, medical students, professionals, and women accessing public health services, FMF has identified barriers to women seeking services and to professionals offering services, and explored myths and beliefs related to cervical cancer prevention among women and among health professionals. By clarifying where the obstacles exist-among providers or users or both-the FMF can make appropriate recommendations for systemic change within the public health system’s cervical cancer prevention program.

Instituto Pampeano para el Desarrollo Sostenible (IPADES)

The Alliance Small Grants Program awarded a grant to IPADES to carry out a study analyzing access by rural women to reproductive health services and specifically cervical cancer prevention. Through interviews and focus groups with health professionals and beneficiaries, IPADES has gathered information about knowledge of and attitudes toward cervical cancer prevention. With the collected input from the community, IPADES has reported their findings to governmental entities to influence plans and policies concerning cervical cancer prevention education and intervention.

Promoción de la Mujer Rural (PRODEMUR)

PRODEMUR’s small grant project had a number of different components, all designed to educate the community and improve women’s health in La Rioja, Argentina. PRODEMUR conducted a study to determine sociocultural characteristics of women at risk of disease and what hinders them from going to a gynecologist; to investigate the extent of women’s knowledge of gynecological disorders and how to prevent them; and to analyze the level of accessibility of health services for older women. PRODEMUR designed and carried out a comprehensive media campaign involving public television and radio ads and print material, all of which provided the public with information regarding the prevention of cervical cancer and invited women to attend a workshop about cervical cancer prevention. The “contact campaign” that PRODEMUR developed included a video to show at the workshops and brochures with written and illustrated information. The workshops covered women’s roles in the family and community, reinforcing women’s self-worth and analyzing the ways in which women neglect their own care, including cervical cancer prevention. Additionally, PRODEMUR offered Pap smears to the women attending the workshops and created a database for follow-up of the results of the Pap screenings.

Armenia

American Armenian Wellness Center

The American Armenian Wellness Center was awarded a grant for a project with the objectives of increasing by 50% the number of screened women of low socio-economic status, ages 35-65, who receive a Pap smear at least once every three years; ensuring that women with abnormal Pap smears receive high-quality follow-up treatment within three months of diagnosis; increasing the number of women who have knowledge of Pap smears; and providing high-quality cervical cancer services through midwives and clinics. Project activities have included public service announcements, training volunteer and professional health workers, distributing literature in public health centers and clinics, surveying women’s understanding and knowledge of cervical cancer, and training nurses and midwives at clinics.

Bolivia

Marie Stopes Bolivia

Marie Stopes Bolivia has received a grant to analyze and improve the knowledge, attitude, and practices of indigenous and low-income women with regards to cervical cancer prevention. Through collaborative efforts with community-based organizations and the health services department of the Ministry of Health, Marie Stopes has conducted interviews and focus groups to identify strategies for overcoming barriers, and has disseminated their findings. To improve levels of public awareness, Marie Stopes has developed materials in various media and in the languages spoken in the target geographic area. In addition, the project has trained health promoters and worked with them to disseminate materials and foster community awareness. Marie Stopes will better equip its center with medical equipment and set up a system for referrals for women with positive cervical test results.

Cameroon

University of Yaounde

Between 2001 and 2002, the University of Yaounde performed a study on the efficiency of VIA screening (visual inspection of the cervix after acetic acid wash). With funding from the Alliance Small Grants Program, 4,813 women were screened in the study: all with VIA, 4767 with Pap smears, and 574 women received colposcopic evaluation. After initially determining that VIA had an acceptable level of sensitivity (70.5%) and specificity (77.6%), the University of Yaounde decided to include it into the national screening program of Cameroon, using cytology as a back-up procedure for the first few years.

Colombia

Academia Colombiana de Salud Pública y Seguridad Social (ASPYDESS)

ASPYDESS, with assistance from the Alliance Small Grants Program, is recreating the way central Colombia works to prevent cervical cancer. In order to accomplish this, the group is revamping existing norms and protocols in place for handling cervical cancer prevention. ASPYDESS has improved mass screening for cervical cancer through work with experts in the field and distribution of up-to-date information about prevention. ASPYDESS has conducted workshops targeting various community stakeholders and health professionals with the goal of improving what young doctors and nurses are taught about screening for cervical cancer prevention. Additionally, ASPYDESS plans on compiling reputable printed materials from Colombia and elsewhere to share with workshop participants as well as with women at the point of service in health care settings.

Democratic Republic of the Congo

Ecole de Sante-Publique de Kinshasa

The School of Public Health in Kinshasa is performing a study comparing cervicoscopy to cytology or HPV DNA testing, using colposcopy and biopsy as standard reference tests for detecting cervical neoplastic lesions. The project is determining the utility of a grading system of abnormal cervicoscopic lesions and of cervico-vaginal infection treatment on the specificity of cervicoscopy. The School of Public Health is also assessing the feasibility and acceptability of implementing a cervicoscopy-based cervical cancer screening program in this specific primary health care setting among a mainly unscreened population. This project will conclude its work in 2004.

El Salvador

Hospital de Diagnóstico

In 2000, Hospital de Diagnóstico was awarded a small grant to study the incidence of invasive cervical-uterine carcinoma among women in El Salvador. Information was collected from cytology and biopsy reports from 1994 to 1998 on the ages and rates of first-time and follow-up cytology screening. Findings showed that 72 percent of cytology tests were performed on young women, ages 15 to 39 years, yet over 76 percent of all carcinoma occurred in older women, ages 40 to 79. Given that the screening policies at the date of the study focused on younger women, Hospital de Diagnóstico concluded that “the population being screened was the wrong one.” At the end of the study, Hospital de Diagnóstico disseminated their findings to various institutions responsible for health policy in El Salvador, including the Ministry of Health, the Pan American Health Organization, and the Interinstitutional Committee of Cervical-Uterine Carcinoma of El Salvador, with the goal of effecting needed changes in national policy for the age at which women are screened.

Asociación Salvadoreña de la Salud (ASPS)

With funding from the Alliance Small Grants Program, ASPS trained nurse/health promoters on techniques of cytological sampling and provided them with basic instruments for carrying out the work. Through the project, ASPS distributed educational material and held educational sessions, with 444 participants, on cervical cancer prevention. Coverage in the targeted area was increased to 75 percent of sexually active women as a result of the efforts of ASPS technicians and health promoters.

Ethiopia

Good Samaritan Association (GSA)

With funds from the Alliance Small Grants Program, GSA established, furnished, and staffed a cervical cancer prevention and control unit. This new development allowed GSA to network with other agencies working to prevent cervical cancer, develop informational materials in Amharic and English, create a resource center for cervical cancer prevention, and advocate for a variety of cervical cancer programs and policies in Ethiopia. This cervical cancer prevention and control project was the first of its kind in Ethiopia.

Georgia

Women Wellness Care Alliance (HERA)

HERA was awarded a grant to improve awareness of cervical cancer and provide screening activities in order to reduce mortality and morbidity rates due to cervical cancer. HERA activities included training community nurse educators; conducting surveys to obtain information on knowledge, attitudes, behavior, and practice toward cervical cancer; promoting cervical cancer prevention through mass media, educational booklets, leaflets, and posters in health education programs; and providing cervical cancer screening services to women ages 30-50, the age at which women are most at risk for cervical cancer.

Guatemala

Asociación Cooperación para el Desarrollo Rural de Occidente (CDRO)

With small grant funding, CDRO created a project to educate the community about cervical cancer prevention and women’s reproductive health issues, and formed a network of health promoters to establish a sustainable system for information dissemination and education. CDRO has designed materials appropriate for indigenous Maya Kiche women, based on local cultures and language, including materials for illiterate women. The materials include both visual and auditory components, which educate on the basics of women’s reproductive anatomy, self-care, and preventing cervical cancer. CDRO has conducted education sessions for both men and women, led by trained reproductive health promoters. Upon completion of the workshops, participants pass along information to their friends and family members, forming a network of promoters to create a sustainable information and education system for the community.

Asociación para la Promoción, Investigación, y Educación (PIES) de Occidente

PIES, with an award from the Alliance Small Grants Program, fostered and promoted community health services for the prevention of cervical cancer in ten indigenous communities of the Western Altiplano of Guatemala. PIES created educational materials, translated into the three languages spoken in the area, which covered six different cervical cancer-related themes. Oral and written information were disseminated at various events, through radio, and at markets in each of the targeted municipalities. Additionally, PIES educated and trained midwives about various topics related to cervical cancer prevention, given that these health professionals have the most contact with local women. In order to increase cervical cancer prevention coverage to women, PIES created radio messages in three languages describing locations of service providers; gave information out at health clinics; provided clinics with equipment, supplies, and medicine; coordinated with APROFAM Laboratories to charge more affordable rates for exams; and carried out community screening campaigns in collaboration with other local groups.

Finca Dos Marías Corp.

A small grant was awarded to Finca Dos Marias to develop a sustainable cervical cancer prevention program in the farming community La Reforma, Guatemala. Through their work, health promoters were recruited and trained (both men and women) to educate women and men about cervical cancer prevention. With help from the health promoters, other volunteers, and the nurse practitioner from the farm’s medical clinic, the project screened hundreds of women (and attracted more women than they were able to screen). The nurse will continue to spend time each week screening women and working with the health promoters in order to sustain this project in La Reforma, where these services were previously unavailable.

Honduras

PROMESA

Through a grant from the Alliance Small Grants Program, PROMESA is working in conjunction with the Emma Romero de Callejas Cancer Center in the Yeguare region of Honduras to improve community awareness of cervical cancer and efficacy of cytology screening for precancerous cervical lesions. After interviewing 505 women, ages 15-79, PROMESA designed individual and group educational and counseling sessions, and created and performed an hour-long radio show on cervical cancer prevention. PROMESA trained health promoters and nurses, implemented cytology brigades, and provided health centers with cytology collection materials. Both U.S. and Honduran medical students and residents participated in the various aspects of the project, including patient interviews, health education and training, database management, and cytology collection. In order to continue to improve detection of abnormalities, PROMESA’s nurse practitioner trained in VIA (visual inspection of the cervix using acetic acid), and she is currently providing VIA and cytology services to women.

Jamaica

FAMPLAN

With small grant funding, FAMPLAN increased the awareness of cervical cancer prevention measures in 32 Jamaican communities. Educational workshops were conducted for health professionals and community women, and the radio and newspapers were used to promote the project and the importance of screening in preventing cervical cancer. FAMPLAN partnered with service clubs, health personnel, hotels, and churches to recruit women for screening, as well as to develop culturally relevant and sensitive educational materials. FAMPLAN developed pamphlets in collaboration with the Jamaica Advancement Movement Against Literacy in order to make pamphlets easy to understand for people with a low literacy level. An educational video (made in Jamaica) about cervical cancer prevention was another effective tool developed by this project.

Kazakhstan

Public Health Institution

In 2002, the Small Grants Program awarded funding to the Public Health Institution in Voxtochno-Kazakstanskya Oblast. The primary objective of the project was to conduct a needs assessment of cervical cancer prevention in the region. Activities include estimating the adult female population, assessing the epidemiology of cervical cancer, studying national health policy and interventions, evaluating the medical infrastructure and treatment options, assessing the availability and types of information, and defining knowledge and attitudes of women and local health professionals towards cervical cancer prevention. At the end of the assessment, the project organized a local round table with those in a position to act upon the project’s recommendations and develop an affordable intervention strategy.

Kenya

International Centre for Reproductive Health (ICRH)

With a small grant from the Alliance Small Grants Program, ICRH established a clinic-based community outreach program for cervical cancer prevention. To accomplish this work, volunteer outreach workers were recruited and trained by Kenyan staff from PATH’s cervical cancer prevention project in western Kenya. The outreach workers sensitized women’s groups, community leaders, and church attendees and referred women to clinics in their area for screening. Printed information about cervical cancer prevention was also distributed, additional door-to-door outreach was conducted in areas not covered by an outreach worker, and follow-up visits were planned for women who had not sought screening, as well as for further sensitization in the village.

Kyrgyzstan

Family and Healthy Generation

Family and Healthy Generation was awarded a small grant to increase awareness about cervical cancer and about prevention and treatment methods in Kyrgyzstan. Project activities included developing an information and education campaign, conducting a training of trainers workshop, and conducting training seminars for health professionals. This project will conclude its work in 2004.

Lithuania

Family Planning and Sexual Health Association

With the grant it received, Family Planning and Sexual Health Association worked to increase awareness about the importance of early diagnosis and treatment of precancerous lesions and to train family doctors on early screening and treatment approaches. Project activities include creating an Internet site on cervical cancer, inviting women to visit specialists through TV and radio advertisements, distributing posters in Lithuania explaining the importance of early screening, and organizing a press conference to introduce the project. These activities have been further supported through training courses for family doctors and through the publication of guides for family doctors.

Macedonia

Center for Family, Motherhood & Childhood Support (CFMCS)

The Center for Family, Motherhood & Childhood Support (CFMCS) received a grant to develop a collaborative approach to cervical cancer screening among local organizations. Project activities included conducting workshops for local health care providers and community health promoters; preparing, publishing, and disseminating information packages; working with local general practitioners to identify and register all women suitable for screening; and establishing cervical cancer screening services in a local health service facility. Early in the project, CFMCS focused on outreach to the community, field visits, and focus groups to strengthen community involvement in prevention efforts. The next three months were spent developing and preparing workshop presentations, tools, and materials. CFMCS held two workshops; the first was aimed at community health promoters and provided basic education about cervical cancer prevention options available in their communities. The second workshop was designed for higher-level health staff and focused on improving counseling and addressing cultural barriers to screening, building awareness of health professionals’ key roles in early detection of cervical precancer, using public health-oriented approaches to screening and treatment, and helping women overcome barriers to screening.

Mexico

Fronteras Unidas Pro Salud, A.C.

Pro Salud received a grant from the Alliance Small Grants Program to train local bilingual (Mixteca and Spanish) health promoters of Valle Verde in Tijuana about cervical cancer and its prevention. After receiving training, the health promoters visited women in the community to educate them and to encourage women to go to the health center and get Pap smears. By recruiting bilingual health promoters, Pro Salud was able to reach non-Spanish speaking women with no prior experience accessing gynecological services or even seeing a doctor as a form of health prevention. Most of these indigenous (Mixteca) and mestiza women were afraid of going for a Pap smear because they thought it was dangerous, did not know of other women who had received Pap smears, or were embarrassed. Through successful education sessions using visual tools to accommodate the high illiteracy rate, promoters were able to inform hundreds of women and provide hundreds of Pap smears through a bilingual health care provider.

Grounds for Health, Inc.

Grounds for Health, through a grant from the Alliance Small Grants Program, created asocial infrastructure to increase awareness and support for cervical cancer prevention efforts as well as for women diagnosed with cervical cancer. They assessed the general demographics and surveyed men and women about reproductive health to gauge knowledge, attitudes, and behaviors toward cervical cancer and its prevention. Five focus groups were then formed to contribute further to data collection. GFH worked with local reproductive health organizations to train volunteer health promoters about cervical cancer detection and treatment of precancerous lesions, and how to support women diagnosed with precancerous lesions and cervical cancer. They worked to increase awareness and outreach to women, all to develop a sustainable community-based mechanism to ensure follow-up of patients and monitoring of quality of care.

Comunicación, Intercambio y Desarrollo Humano en América Latina (CIDHAL, A.C.)

CIDHAL’s small grant award has supplemented the efforts of the Midwives Project, which trains traditional midwives and health promoters to provide culturally sensitive cancer education and early detection of cervical cancer to women in Morelos, Mexico. Through educational workshops in marginalized communities, CIDHAL has increased awareness of cervical cancer prevention. They plan to expand the current project by recruiting and training new midwives as well as providing further training to the existing midwife team. CIDHAL has also worked to strengthen collaborative efforts with government health services, health professionals, and other interested community agencies through sharing of project results, community fundraising events, and workshops in the community.

Moldova

Against Infectious Diseases in Obstetrics and Gynecology of Republic of Moldova (AIDOGRM)

With funding from the Alliance Small Grants Program, AIDOGRM has worked to increase women’s knowledge of cervical cancer and to strengthen the professional skills of gynecologists and family doctors. Activities have included recruiting a working group of experts to develop educational materials; creating a variety of educational materials for health providers and women to distribute and use during trainings; providing workshops for doctors to improve knowledge of cervical cancer prevention, diagnosis, and follow-up; and holding informational seminars for women about cervical cancer. A hotline for easy access to information about cervical cancer prevention has been established and prevention messages have been disseminated through television and radio. A Round Table will be conducted with Ministry of Health policymakers at the end of the project in 2004.

Mongolia

The National Cancer Center

This small grant funded a pilot project to implement VIA (visual inspection of the cervix using acetic acid) in Mongolia. The project used a multi-step process that involved training health care workers, recruiting women to receive VIA screening, and assessing the effectiveness of this screening method. Midwives, family doctors, and ob-gyns were trained to use VIA to screen for cervical precancer. Participants were recruited through clinics in Mongolia, information meetings, local school associations, and television announcements. This project will conclude its work in 2004.

Nicaragua

Servicios Médicos Comunales (SMC)

With funding from the Alliance Small Grants Program, SMC trained 115 health promoters, who in turn made 3,450 house visits and distributed brochures with information about cervical cancer. In response to the invitations to screening that were distributed to women older than 30 years, 1,180 women went to health centers to be screened. Through their work with the health promoters, SMC increased coverage of women being screened and provided information about cervical cancer among a population with few economic resources.

Peru

Instituto Peruano de Paternidad Responsable (INPPARES)

This project allowed INPPARES to develop a community-based program to educate health professionals and community members, encourage women to be screened for precancerous lesions and cervical cancer, and treat dysplasia and pre-malignant lesions, with a focus on women in marginal areas. Through collaborative work with hospitals, local and international organizations, and the Ministry of Health, INPPARES trained obstetricians on cervical and other cancers affecting women and procedures for performing Pap smears and VIA screening. INPPARES also created “Mobile Campaigns” to provide screening services to women without access to clinics or transportation. Educational outreach was conducted through various community settings and groups, including visiting popular eating places, food subsidy groups run by women, mothers’ clubs, and housing associations, ultimately reaching out to thousands of women in Peru.

Russia

Sakhalin Society of Obstetricians and Gynecologists

The Sakhalin Society of Obstetricians and Gynecologists was awarded a small grant to determine why cervical cancer is not being detected in Sakhalin until the late stages. Activities included conducting a needs assessment to define the strengths and weaknesses of the current cervical cancer prevention program. Upon completion of the assessment in 2004, the Sakhalin group will develop a strategy for improving the program, and will work with the Sakhalin Oblast Health Department to institute changes.

South Africa

Gender Advocacy Programme

The three main goals for this small grant project were to develop a logo to represent cervical cancer prevention, promote cervical cancer prevention in the poorer and disadvantaged communities of South Africa, and create awareness among women that their health needs continue after childbirth. To accomplish these goals, the Gender Advocacy Programme designed and marketed a logo, which is now displayed on its reproductive health literature and correspondence. They also developed and distributed posters and pamphlets in three languages regarding clinics and service providers in Western Cape and promoted women’s rights regarding reproductive health with cervical cancer prevention as the theme of the 2002 International Day of Action for Women’s Health.

Serbia and Montenegro

Institute of Obstetrics and Gynecology Clinical Center of Serbia

Institute of Obstetrics and Gynecology Clinical Center of Serbia and Montenegro received a grant to identify factors that influence women’s cervical screening behavior and to investigate barriers to cervical screening through research that was qualitative (focus-group discussions and in-depth interviews) and quantitative (a community-based survey). By July 2003, the Institute had completed and reported on the first phase of their plan, which included conducting focus groups and more in-depth interviews. This project will conclude its work in 2004.

Sudan

African Organization for Reproductive Health and Social Development (AORHSD)

With funding from the Alliance Small Grants Program, this organization has launched a pilot project initiating a cervical cancer screening program in Kordofan state, Sudan, using VIA for screening and cryotherapy for treating precancerous lesions. The organization anticipates that the results of the project, to be completed in 2004, will influence policies and guidelines with respect to cervical cancer prevention and will encourage the reallocation of resources in order to implement these services in a national screening program.

Thailand

Prince of Songkla University

With assistance from the Alliance Small Grants Program, this university worked for two years to create a more effective referral system for women in southern Thailand with abnormal Pap smears. In order to accomplish this goal, the university evaluated both the competency level of health professionals offering cervical cancer prevention services and the technology, equipment, and facilities being used. From the research and evaluation conducted, recommendations were drawn up for improvements in areas where hospitals were weak or limited. Additionally, they set up a registry system for women with abnormal screening results, and created a means of monitoring the quality of the referral system.

Ukraine

The Regional SALUS Foundation

Funds awarded by the Alliance Small Grants Program enabled the SALUS Foundation to disseminate information about cervical cancer; the possibilities for prevention, diagnosis, and treatment; and locations of local sources for screening and treatment. SALUS Foundation created a telephone help line to provide information about cervical cancer screening and treatment to women in and around Lviv. SALUS also distributed over 10,000 leaflets to women, doctors, and clinics to advertise the telephone line. They published three separate leaflets on cervical cancer prevention-Pap tests, biopsy, and colposcopy-to be utilized during trainings and round tables in and around Lviv. Additionally, SALUS developed and broadcasted four radio programs on cervical cancer prevention. SALUS also conducted training workshops about cervical cancer prevention, screening, and treatment, attended by some 250 professionals and medical students.

Viet Nam

Center for Reproductive and Family Health (RaFH)

As a small grant recipient, RaFH assessed the knowledge, attitudes, and practices of health care workers and community women about cervical cancer and prevention. They examined the knowledge of health workers at various levels-provincial, district, and commune-through focus-group discussions and in-depth interviews, and found common themes among all. After finding a general lack of knowledge about cervical cancer prevention, diagnosis, and education as well as an absence of diagnostic and prevention services, and an underestimation of the prevalence of cervical cancer in the area, RaFH suggested a number of ways to address current attitudes and practices. Their recommendations included increasing coverage of services and providing further training to health professionals, investing in new and better equipment, and educating community women through mass media information dissemination. RaFH also suggested a change in health policy, making cervical cancer diagnosis, prevention, and treatment services free of charge with a specific insurance card (new) or at a very reduced rate for low-income patients.

The Viet/American Cervical Cancer Prevention Project

The Alliance Small Grants Project awarded a small grant to this organization to train four Vietnamese pathologists for three months in the United States. The successful completion of the training helped to ensure that provision of high-quality Pap screening would be available for women age 30 to 55 in metropolitan Hue at least once every five years. Additionally, the trained pathologists themselves trained other personnel.

Zimbabwe

University of Zimbabwe, Department of Obstetrics and Gynaecology

After receiving a small grant from the Alliance Small Grants Project, the University of Zimbabwe Department of Ob/Gyn implemented a pilot project for cervical screening by VIA (visual inspection using acetic acid) in a rural Zimbabwean district. At the conclusion of the project year, 9 of the 15 clinics targeted by the project had successfully instituted VIA screening after personnel had been trained at the district hospital.

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