This strategy was published in 2020 and can be downloaded here:
https://www.who.int/publications/i/item/9789240014107
'This global strategy to eliminate cervical cancer proposes:
a vision of a world where cervical cancer is eliminated as a public health problem;
a threshold of 4 per 100 000 women-years for elimination as a public health problem;
the following 90–70–90 targets that must be met by 2030 for countries to be on the path towards cervical cancer elimination:
90% of girls fully vaccinated with HPV vaccine by age 15 years
70% of women are screened with a high-performance test by 35 years of age and again by 45 years of age
90% of women identified with cervical disease receive treatment (90% of women with precancer treated, and 90% of women with invasive cancer managed).'
The following three extracts are especially relevant to our discussion:
1. 'A robust understanding of the social, cultural, societal and structural barriers to the uptake of services is crucial. Such knowledge will inform the development of context-specific and culturally appropriate demand creation strategies and the design of acceptable, accessible service delivery platforms. Local communities, especially women, must be engaged and empowered to lead the development of these critical programmes, serve as allies, counter misinformation or stigmatization, and support those needing more complex treatment. Increasing health literacy, knowledge of rights and awareness of cervical cancer prevention and control will help to mobilize, empower and engage communities and civil society, and women in their diversity.
COMMENT (NPW): This resonates with the objective of our HIFA discussion: 'Insights from the discussion will be brought together in a report and help shape future advocacy and knowledge products that support efforts to improve uptake of cervical cancer screening and treatment to accelerate progress towards the 2030 elimination targets'. However, 'a robust understanding of the social, cultural, societal and structural barriers' requires a comprehensive and holistic approach, for which a 6-week discussion on HIFA can only be a small part. As the global strategy says, 'local communities, especially women, must be engaged and empowered', which goes way beyond an informal online discussion. We invite HIFA members not only to share experience, but also to point us to previous research and work on this topic.
2. 'Reduce cancer stigmatization: Patient awareness, health literacy and education initiatives, especially through survivor groups, contribute to addressing stigmatization associated with cancer.'
COMMENT (NPW): Indeed cervical cancer survivors can play a uniquely powerful role in educating other women about screening, diagnosis and treatment because they speak from lived experience. They can help dispel myths, reduce fear and normalise discussions about cervical cancer. They can provide peer support, helping newly diagnosed women navigate the healthcare system, understand treatment options, cope emotionally, and adjust to life during and after treatment.
3. 'Media platforms, opinion leaders, influencers, traditional and faith leaders, and patient advocates should be deployed strategically in order to increase access to information. The WHO guidance on community mobilization, education and counselling for cervical cancer prevention and treatment can be used to improve health literacy'
COMMENT (NPW): This WHO guidance is actually a chapter in a 2014 WHO publication called 'Comprehensive cervical cancer control: a guide to essential practice, 2nd edition.' Geneva: World Health Organization; 2014
https://iris.who.int/items/30e47177-9f70-4e73-b130-2cfe0fd374fa
The guidance is a lot more than improving health literacy. Indeed the term 'health literacy' is not mentioned in the publication. Here is the introduction to the chapter:
'This chapter addresses the need to include outreach, community mobilization, health education and counselling in effective cervical cancer prevention and control programmes. The goal of these strategies is to motivate women and families to seek preventive services, including early detection and treatment of cervical pre-cancer and vaccination of girls, and ultimately to enable people to increase control over and improve their health.
'This chapter consists of five main sections. Section 3.1, Increasing the use of cervical cancer prevention and control services, serves as an introduction to the subject of this chapter, with a focus on the central role of health-care providers. The remaining
sections, on Outreach (section 3.2), Community mobilization (section 3.3), Preventive health education (section 3.4) and Counselling (section 3.5), provide information on the most effective approaches and key messages for each of these efforts, including
helpful resources for implementing them. The transmission of consistent messages requires good communication skills and the use of nontechnical language appropriate to the target population.'
I shall take a closer look at this chapter in the coming days.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org