APGO

Poster
Tracy E. Irwin, MD, MPH

Andrew Dykens, MD, MPH , Karen Peters, DrPH, Youssoupha N’Diaye, MD, MPH, PhDc , Paulette Grey, MD, MPH , Melody Mumford, MD

Background: Senegal has a population of 3.20 million women ages 15 years and older who are at risk of developing cervical cancer. Although cervical cancer ranks as the most frequent cancer among women between 15 and 44 years of age in Senegal, there is currently no widespread cervical cancer screening program in rural Senegal.

Objectives: 1) Conduct a feasibility study partnering University of Illinois faculty with Peace Corps Senegal to train local workforce on cervical cancer screening (VIA). 2) Incorporate residents and medical students in development of curriculum and participation in training 3) Improve cultural competency of residents and medical students

Methods: The University of Illinois Departments of Family Medicine, OB/GYN, and School of Public Health partnered with a local co-investigator as well as Peace Corps in Saraya Health District, Senegal. We conducted community health assessments to identify the priority issue of cervical cancer. We subsequently engaged residents and medical students to develop a curriculum adapted from World Health Organization training materials, which we used to train Senegalese health care workers in the VIA methodology of cervical cancer screening. The Peace Corps volunteers provided cultural facilitation of the group and training. Trainees actively participated in health systems strengthening and workforce development. They were expected to give lectures, participate in training and journal about their experience with a focus on cultural differences and health disparities.

Results: We have trained five new trainers in the technique of visual inspection of the cervix with acetic acid. These trainers, in turn, trained 14 additional personnel as a secondary training during our January 2011 visit to Saraya, Senegal. From the trainee perspective: “Our first patient for cervical cancer screening had no idea of her age. Since we're screening women age 30-50, age is a critical factor. Once again, all I could do was shake my head in awe at the amount that can be accomplished with so many challenges…” Paulette Grey, Resident. “I had a long talk with one woman…The big sisters encouraged the women in their village to visit the health post for prenatal visits and the hospital for deliveries. She asked more questions about cervical cancer and I was happy to spend time discussing it with her.” Nora Roberts, Medical Student.

Conclusion: This model fosters collaboration between a health region in a low income country, a university, the Peace Corps, and Peace Care to sustainably improve health care delivery through health systems strengthening and workforce development while, as well, providing training in global health and cultural competency for U.S. health care trainees. There is considerable potential to scale the model, increase resident and student participation through partnerships with local communities, universities and development agencies.