Cervical Cancer Awareness and Knowledge Campaign: Health Promoters of Rural El Salvador

1. Cervical Cancer Awareness and Knowledge Campaign: Health Promoters of Rural El Salvador Proposal by Basic Health International, Inc.

2. The basics about Basic Health International (BHI) NGO founded by Dr. Miriam Cremer, MD MPH at Mount Sinai School of Medicine, New York City. Our Vision: Eradicate Cervical Cancer in Latin America and the Caribbean. To achieve this goal we: Train healthcare providers in low-cost, low-tech methods of cervical cancer screening and treatment Provide Direct Patient Care Conduct research Help shape cervical cancer policy

3. El Salvador Needs Assessment: cervical cancer is the primary cancer killer of women in El Salvador.

4. El Salvador Needs Assessment continued… This is due to the fact that women of rural El Salvador have a very low rate of cervical cancer screening. There is also a vast lack of knowledge about the human papillomavirus (HPV). Encuesta Nacional,de Salud, FESAL 2008 Familiar. October 2009

5. MISSION OF PROPOSED PROGRAM Improve the awareness and knowledge of HPV infection and cervical cancer prevention among health promoters serving the Department of San Vicente, El Salvador.

6. SCOPE OF WORK Develop a curriculum for health promoter education on cervical cancer prevention. Conduct education trainings for the health promoters of the Department of San Vicente, El Salvador. Work with the health promoters to develop a targeted cervical cancer prevention program for members of their communities. Health promoters studying cervical cancer prevention material. Ethel Peralta. BHI Program Manager, explaining forms to health promoters and nurses during a Basic Health delegation.

7. TARGET POPULATIONS 125 Health Promoters working in San Vicente, El Salvador: It is our goal to provide health promoters with a comprehensive knowledge-base about HPV and cervical cancer. During the course, health Promoters will develop targeted informational campaigns for: Sexually active women Goal: To improve knowledge about methods to prevent cervical cancer, and to improve understanding of the history of HPV and its progression to cervical cancer. Sexually active men Goal: To encourage involvement in the process of cervical cancer screening with their partners, decrease the negative stigma associated with gynecological exams in order to ensure they are not a barrier to their partner’s cervical cancer screening and treatment.

8. Program of Action WHO ARE HEALTH PROMOTERS? Health promoters are members of the rural community that keep track of their constituents health needs, and informs about disease prevention and healthcare campaigns. BHI BHI technical advisors will conduct cervical cancer awareness trainings to the health promoters in order to arm them with tools necessary to successfully educate members of their community. HEALTH PROMOTERS Health promoters will develop targeted campaigns for their community, with a focus on presenting information to both men and women. MEN WOMEN

9. Program of Action: Health Promoter training

10. Outcomes • Quantitative improvement in health promoter knowledge of HPV infection and cervical cancer prevention (pre-and post course tests). • Implementation of educational HPV/Cervical Cancer campaigns reaching over 73,000 rural Salvadorans. • Free web-based programmatic materials to implement health promoter education course in low-resource settings globally. • Program description and outcomes published in peer-reviewed journal.

11. Cervical Cancer Informational brochure we have developed and distributed to health promoters

12. Please go to http://www.youtube.com/BasicHealth to view a short video about Basic Health International’s work in El Salvador. Please refer to our website www.basichealth.org for more information. The following slides provide additional background information about Basic Health International.

13. BHI and Policy • Develop national cervical cancer guidelines with the Ministry of Health, including the integration of the single-visit approach into an existing cytology program. • Conduct annual regional Cervical Cancer Screening Symposium in San Salvador, El Salvador. (Upcoming event January 28, 2010) • Work with community organizers to develop the best practices to implement cervical cancer screening initiatives and programs. Dr. Miriam Cremer, President and Founder of BHI, talking at the 2008 cervical cancer symposium. Over 250 people from Central America attended the 2008 cervical cancer symposium.

14. Training: OBGYNs, Generalist Physicians, Nurses and Health Promoters • BHI holds tri-annual delegations to El Salvador during which Salvadoran Healthcare providers receive a 5-day training on visual inspection with acetic acid and cryotherapy. Women waiting in line for their exam. BHI trainer Dr. Rachel Masch training Salvadoran physician.

15. Patient Care:Number of women screened during delegations between 2006 and 2008.

16. 2006-2008: Lesions and Invasive Cancers Detected • 72 pre-cancers have been treated. • 8 invasive cancers have been detected and treated.

17. Research • 11 Publications • 21 Abstracts • First prize for original research, Federation of Latin American Obstetrics and Gynecology (FLASOG) Conference, San Salvador, El Salvador, 1999 • 14 current research projects

18. THANK YOU Contacts: Dr. Miriam Cremer, President and Founder miriam.cremer@mssm.edu Dr. Mauricio Maza, Medical Director mmaza@basichealth.org Lauren Ditzian, Program Manager lditzian@basichealth.org www.basichealth.org