Albania,bi h,macedonia,kosovo

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Albania,bi h,macedonia,kosovo

  1. 1. GROUP WORKWorking Meeting on Comprehensive Cervical Cancer Prevention and Control in UNFPA EECARO and ASRO countries Antalya, Turkey May 18-20
  2. 2. Group work by teams of countriesOBJECTIVETo identify 4 priority actions to improve existing programmes ordesign a new programme (if there is not any cervical cancerprevention and control programme in the country).3 STEPS/ GROUP WORK SESSIONS I) Success stories and challenges**** II) Four priority actions III) Operationalization of the actions****
  3. 3. Group work by teams of countries1) Use what we learned yesterday2) Use the Programme Guidance for Countries- English,French, Russian3) COMPREHENSIVE programme4) Pay particular attention to disadvantage groups
  4. 4. Group work by teams of countries Session I: Success stories and challenges1) ADVOCACYi)Target groups?ii) Key messages for each target group?iii) How can messages be delivered?iv) How can we mobilize communities?v) Challenges?vi) Opportunities?2) VACCINESChallenges and opportunities to introduce/sustain HPV vaccination in yourcountry3) SCREENING AND TREATMENTI)Challenges and opportunıtıes to have national population based screeningprogrammes and early treatment precancerous lesions.II)Type of screening methodology and treatment modalities than can beused in the country.
  5. 5. Group work by teams of countries Session I: Success stories and challenges Albania, BiH, Kosovo, Macedonia, CHALLENGES OPPORTUNITIES BiH: Funding Macedonia: Coverage, proper targetting Kosovo: no health insuranc at all All: -Readiness and willingness of civil - Lack of data for evidence-based advocacy (lack of quality society to support the issue baseline data); -- RH on the political agenda - Lacking Cx Ca information system; -Readiness of UNFPA and donor - Lack of technical expertise for tailored campaigns, community to support the issue - Right timing -Reginal cooperation /initiative - Lack of understanding of the community practices -- The existance of some advocacy - Lack of BCC targeted campaign approach; Lack of adequate materials of relevance for the wholeADVOC comprehensive services region, with some adaptation (song, ACY - Values and cultural factors to advocacte for SRH issues pamphlets..) - Ad hoc-activities --Many commonalities that would - Funding health is not a priority under EU integration justify sub-regional approach for processes, amongs other more pressing issues advocacy and expecting positive - Political context that interferes with health priorities raction by the stakeholders - Grass-roots mobilisation -Existing advocacy: condom use -Focus target on women only promotion as entry point into -Lack of experience in targetting men: how to target them advocacy for men -Lack of evidence, especially for how HPV affects men, to use as advocacy tool - Targetting vulnerable groups (ie: Roma)
  6. 6. Group work by teams of countries Session I: Success stories and challenges Albania, BiH, Kosovo, Macedonia, CHALLENGES OPPORTUNITIES -Financial resources -- Models of integration in the current systems - Cultural beleifs: the vaccine “encourages girls to have sex” “encourages promiscuity” -New vaccine: lacking evidence for the impact -Duration of vaccine effect: 8 years only -It prevents the infection -Vaccine only targets girls (lack of understanding: --The region has a good tradition inVACCINATION why not vaccinate men, as the carriers and effective vaccination transmitters of HPV) - -- Unlcear messeges to pass to the parents - Vaccine not introduces systematicly in the PHS , except in Macedonia.
  7. 7. Group work by teams of countries Session I: Success stories and challenges Albania, BiH, Kosovo, Macedonia, CHALLENGES OPPORTUNITIES - Preparedness of the health system - Existing of a screening pattern may pose a barrier for transforming it into a more efficient one (PAP test screening) - instead of primary health care systemised visual inspection as screening method that could be much more effective -- Functional healht systems - Demanding logistical and administr. arrangements (repeat visits..) and relatively good -Opportunistic screenings mostly in place (gynecologica lcheck up, and as a part of infrastructure to build upon. it „maybe‟ HPV check. (Health insurance covering -Monitoring and evaluation of efficiency of the programme is still weak treatment in most countries -Various stages of developing the clinical protocols for the comprehensive except Kosovo). screening and treatment programmes; various stages of financial coverage.. - Good evidence to - Various levels of functioning of referral systems demostrate that other - There are gups in public health system financing of services needed screening methodologoes -Human resources an issue for proper PAP smear reading can work and otherSCREENING - The structure of the health system itself (family medicine; ongoing reforms..) – programmatic approaches confusing.AND -Not enough trained nurses can work.TREATMENT -The willingness of civil -Health information system have gaps : quality of the date an issue, largely health society to put pressure on the facility based, not population based register government to deliver -Gaps and delays between check ups and follow ups services for Ca Cx prevention -Unevean situation relating to clinical protocols and their application and quality -Opportunity for links control between MoHs and CSOs . -- Situation variable relating to treatment of pre-canot lesions standardissation -CaCx inclded in wider - Public health system does not perform HPV DNA testing, only in the private strategic contexts for RH sector and in ad-hoc manner -Similarities in the countries -Health system not supported by community involvement, is very oriented towards that favou experience sharing specialised care . -Gynecologists often resistant to empowering nurses more in engaging preventive activites in primary health care. --
  8. 8. Group work by teams of countriesOBJECTIVETo identify 4 priority actions to improve existing programmes ordesign a new programme (if there is not any cervical cancerprevention and control programme in the country).3 STEPS/ GROUP WORK SESSIONS I) Success stories and challenges**** II) Four priority actions III) Operationalization of the actions****
  9. 9. TEAMS OF COUNTRIES EECARO ASRO Kazakhstan Egypt Kyrgyzstan Lebanon Tajikistan Syria Turkmenistan Uzbekistan Facilitator: Magdy Khaled Facilitator: Rita Columbia Armenia Algeria Azerbaijan Morocco Georgia Tunisia Turkey Facilitator: Mohammed Lardi Facilitator: Philip Davies Moldova Russia UkraineFacilitator: Tamar Khomasuridze Albania Regional and global participants join teams Bosnia and Herzegovina Kosovo Macedonia Facilitator: Tatjana Shikoska
  10. 10. Group work by teams of countries Group work until lunch time (-13:00) EECARO teams in Ball Room III ASRO teams in Plaza Room (-3 floor)PRESENTATIONS AFTER LUNCH (14:00-15:30) 10 MINUTES PER TEAM

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