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IHI's Cervical Cancer Program in Haiti.

Cervical cancer is the second most common cancer among women across the world. The World Health Organization's (WHO) principal strategy to control cervical cancer is based on community education, prevention and screening of precancerous lesions.

In a country like Haiti where resources are limited, one of the prevention methods recommended by the WHO is visual inspection with acetic acid (VIA) followed by treatment of identified lesions through this method with cryotherapy (known as see and treat). IHI is helping the Haitian Ministry of Health (MSPP) to implement this method into the basic reproductive health care package offered by the country's public hospitals. The integration of the method into the package has consisted of a number of components, including:

1) Formal training of the see and treat method to obstetricians/gynecologists and nurses at each of the target hospitals across the country. This involves learning the VIA method and how to complete cryotherapy.

2) The sensitization and education of communities across the country regarding prevention of the disease and the appropriate treatments.

3) The provision of the necessary materials to carry out these activities and coordination with the heads of institutions across the country to achieve sustainability of these services.

What have IHI and the MSPP already achieved? So far, we have integrated the above components in the north, northwestern, Artibonite and southeast departments (Haiti is divided into 10 departments). In the north, we have already screened 57 women and trained 2 nurses and 4 physicians in the VIA and cryotherapy techniques. In the Artibonite department, we have screened 168 women and trained 4 nurses as well as one physician. These are just some of the numbers.

The number of women we screen and the health care personnel we train continue to grow on a weekly basis. In some departments, we have reached our initial goals of screening and training. In other departments, there is still more work to be done. The small achievements we have made so far represent the larger vision of IHI to support the MSPP in the prevention of cervical cancer across Haiti through the see and treat method. As we continue to sensitize and educate communities throughout the country, we anticipate screening and treating more women. As the number of trained health care professionals and the demand for services increases in the coming months and years, we expect that cervical cancer will no longer occupy its current position as one of the leading causes of death of women in Haiti.

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