Bristol-Myers Squibb Foundation Secure
the Future
Technical Assistance Programme
(BMSF STF TAP)
SwazilandBreast and Cervical Cancer Network (SBCCN)
REGIONAL FOCUS: / Swaziland: Manzini, Hlathikhulu and Mbabane,
SCOPE OF PARTNERSHIP: / To conduct training for SBCCN on leadership and governance; Awareness Education, Monitoring and Evaluation, Data Management and capacity building in HIV/Oncology partnerships.
OBJECTIVES: / To create an on-going training system in rural Swaziland to empower communities onbreast cancer, cervical cancer and HIV awareness and increase knowledge on prevention, screening and early detection.
VALUE OF ASSISTANCE: / US$73,076.75
PERIOD OF ASSISTANCE: / 18 months
BACKGROUND
Swaziland Breast and Cervical Cancer Network (SBCCN) is one of the principal providers of breast and cervical cancer services to the population of Swaziland. SBCCN operates three breast cancer clinics which offer free consultations, examinations, diagnosis and referrals in ManziniCity, HlathikhuluGovernmentHospital and MbabaneGovernmentHospital. It has also established screening services for cervical cancer at the same centre’s. The clinics use Visual Inspection with Acetic Acid (VIA), a quick diagnostic method, along with cryotherapy to detect suspicious cells.
INITIAL PARTNERSHIP
Prior to the partnership with BMSF STF in 2010, SBCCN did not have an independent strategy for reaching out to communities with awareness messages abouton testing for breast, cervix, prostrate and testicularcancers. SBCCN’s approach was to lurch onto campaigns by peer organizations, partnering with them to educate and screen for the diseases using the clinical and self breast examination methods. BMSF TAP assistance provided SBCCN the opportunity to work autonomously. The organizationexplored virgin territory, in Ngculwini Village, where they were able to monitor and track the success of their project without the influence of other health interventions.
The thrust of thecollaboration was to provide capacity for SBCCN in Leadership and Governance; Data Management;Awareness Education, and Monitoring and Evaluation.
Technical assistance is provided to the organization at executive and volunteer level. Training commenced at the inception of the partnership with assistance on leadership and governance for theboard of directors. The role of the board was clarified and strengthened to the end that the executives now undertake an active role in the formulation and implementation of a variety of fundraising strategies to complement available resources. They actively participate in creating visibility for SBCCN initiatives and facilitated the recruitment of the Executive Director.
BMSF STF followed up the board’s initial training with further TAP assistance on the review of financial performance to enable the board members to determine areas requiring resources and implementation of a diversified approach to resource mobilization.
Technical assistance on community mapping, mobilization and monitoring and evaluation for SBCCN staff and volunteers is provided on an ongoing basis. TAP was also provided on the development of a strategic action plan for HIV and breast/cervical cancer education and healthcare. The plan offers various innovative approaches to create awareness, screen, treat and prevent the cancers. For example, SBCCN uses cancer survivors to spread messages on the diseases and Training of Trainers (TOT) for Rural Health Motivators (RHM).
SBCCN’s vision is to establish an oncology unit to provide chemotherapy programmes for patients within the borders of Swaziland. As they press towards this ultimate goal, they focus on the immediate workable strategy todevelop the capacity of medical personnel to manage breast and other cancers through workshops, seminars and attachments to oncology units of health services sectors in South Africa.
EXTENDED PARTNERSHIP
SBCCN is consolidating and extending the RHMs’training programme on HIV/Oncology that was initiated in Ngculwini. The pilot programme revealed that greater capacity in screening for cervical abnormalities at community level would also significantly benefit the population in that region.
In the replication programme, SBCCN is training a group of clinic staff in Visual Inspection with Acetic Acid (VIA), which is a well-established, inexpensive, instantaneous method for assessing cervical abnormalities.
THE RESULTS
  • Policies and operational systems and procedures have been developed and implemented to facilitate the work of the SBCCN.
  • Awareness has been raised on the various aspects related to breast cancer, including the increasing incidence of the disease, promotion of breast self-examination, annual medical examination and the importance of early diagnosis and treatment.
  • A patient referral tool has been developed.
  • Trans-border relationships have been built with partners in South Africa to consult with and train nurses and doctors for the diagnosis and treatment of breast and cervical cancer.
  • Thirty two (32) health providers, 8 nurses and 24 RHMs, were trained on HIV/AIDS and its relationship with breast and cervical cancer.
  • One thousand community members (700 hundred school children and teachers; 300 church members) received direct awareness and sensitisation on HIV/Breast Cancer/Cervical Cancer from the SBCCN Awareness creation Team
  • 550 community members from 90 homesteads at the Ngculwini community were educated by the trained RHMs. 76 of the women were counselled to be screened for HIV as they presented HIV related conditions.
  • The only clinic in the community was capacitated to provide comprehensive HIV management (integrated with breast and cervical cancer education) for the community.
  • Income Generating Activity where the women make beaded breast cancer ribbons was set up for women in the community with 13 women in the pilot project.
  • Breast and cervical cancer awareness and screening campaign conducted at Ngculwini community with 123 people screened (4 males and 119 females) for breast cancer and 1 screened for cervical cancer. The lady screened for cervical cancer is also HIV positive.
LESSONS LEARNED
  • Using clinic staff and RHMs was effective in channeling campaign messages. 70% of the communitymembers received information about HIV and breast/cervical cancers from the community clinic and/or the RHMs.
  • The use of the RHMs is a best practice in that RHMs already exist within the government health delivery structure and receive a stipend from Government. Consequently, the project did not have to pay for their services, making the strategy more sustainable.
  • People now find the need to know their HIV status to help avert contraction of further disease that may occur due to the break down in the immune system, since they are now aware of the link between HIV and breast/cervical cancer. Seventy-six (76) out of the 300 people educated tested positive after being screened.
  • Electronic media are an effective way to mobilize the community. 90% of community members who attended the community breast cancer screening said they heard about it through radio and/or RHMs.
  • Good collaboration with the chief of the community who mobilized his community elders to support the project ensured good community acceptance and participation in the community activities.