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Madame Fatou Traore (left), director of the Sage Femme (Midwives) de region Kedougou, and Dr. Paulette Gray, a resident in family medicine at the UIC College of Medicine, review a training manual for midwives learning a low-cost method to detect cervical cancer.

Most countries have developed at least one national policy, strategy or plan to address chronic diseases, such as cardiovascular diseases, cancers, chronic obstructive lung disease and diabetes. Progress is slow in low- and middle-income countries, however, for several reasons:

• Compared to wealthy countries, low- and middle-income countries dedicate lower percentages of their gross domestic products to health. In 2009, for example, low income countries devoted $25 per person to health, whereas high-income countries spent more than $4,600 per person. (See the source of this info.)
• When a chronic disease policy, strategy or plan exists, often it is not yet in operation, or funding has not been dedicated to implement it.
• Evidence-based solutions to strengthen local primary health care services have not been widely adopted among lower-income countries.

As a collaborating center in the CDC Global and Territorial Health Research Network, the Illinois Prevention Research Center (PRC) translates innovative policies and interventions that promote health and prevent chronic disease in low-resource settings.

Under the direction of Andrew Dykens, MD, MPH, and Karen Peters, DrPH, we work to increase access to primary health care services and improve health status in low- and middle-income countries.

Cervical Cancer Prevention and Policy Development in Senegal

In December 2014, the World Health Organization established guidelines to reduce the global toll of cervical cancer, which disproportionately kills women in low- and middle-income countries. About 229,500 women in developing countries die of the disease every year.

The Illinois PRC is working to increase Senegal’s capacity to provide cervical cancer screening in rural areas through a partnership with Peace Corps Volunteers and academic researchers. With our partners, as of February 2016, we have trained over 60 midwives in Kedougou to use a simple method to detect cancer on the cervix — VIA, or visual inspection with acetic acid. We also are providing expertise for a national Senegalese policy to address cervical cancer.

We will assess the horizontal (cross-regional) and vertical (national) scaling of cervical cancer prevention policy and evaluate a new model of partnership involving the national and regional health systems, local health care providers, rural communities, U.S. Peace Corps Volunteers, and academic researchers.

The intervention will use community participation in health services quality improvement and policy development to implement and institutionalize policy that promotes access to cervical cancer prevention services in the rural Senegalese regions of Kedougou and Sédhiou that eventually can be scaled nationally. If our model is successful, we intend to build a similar effort in Colombia, where we have established some relationships.

SCIENTIFIC LEADERSHIP

As co-principal investigators, Andrew Dykens, MD, MPH, and Karen Peters, DrPH, direct the Illinois PRC’s collaboration in this special interest project. Both scientists have extensive experience in community-based participatory research not only in the United States, but in countries in Africa and Latin America. Dr. Dykens founded the nonprofit organization Peace Care, which established the partnerships involved in this cervical cancer study.

Other members of the Illinois PRC team on this special interest project are:

• Tracy Irwin, MD, MPH, co-investigator, University of Washington
• Tina Schuh, graduate research assistant

OUR COMMUNITY PARTNERS

• Institute of Health and Development in Dakar, Senegal
• Peace Corps Senegal
• Residents, health care providers, and health systems in the rural communities of Kedougou and Sédhiou in Senegal
• Universidad de Antioquia, National School of Public Health, Columbia

TRAINING

Graduate students in the UIC School of Public Health, including two participants of the School’s Peace Corp Master’s International Program, are developing community-based participatory research skills as part of this project.

PARTICIPATING IN A CDC THEMATIC RESEARCH NETWORK

The Illinois PRC is a member of the Global and Territorial Health Research Network (GTHRN). Funded by CDC’s Division of Population Health, this network identifies and translates innovative policies and interventions that promote health and prevent chronic disease in low-resource settings.

Network members also develop research agendas to prioritize interventions for diverse communities including those in the U.S.-affiliated Pacific Islands, Puerto Rico, and the U.S. Virgin Islands. This network ultimately aims to put such chronic disease prevention research into practice around the world.

In addition to Illinois PRC, this global health network includes PRCs at these institutions:

• University of Rochester, network coordinating center
• Yale University

The network also collaborates with scientists at the University of Hawaiʻi at Mānoa and the University of Puerto Rico as well as affiliated partners at the University of North Carolina, Chapel Hill, and the University of South Florida.

LEARN MORE

In September 2015, scientists in this network published a paper about women with cervical cancer. Read about their findings in our blog.

View a May 2015 presentation about this cervical cancer project in Senegal.

On the World Health Organization’s website, read the WHO’s global plan to reduce deaths caused by cervical cancer, and see some statistics on Senegal’s public health.

Illinois PRC works to reduce chronic disease in vulnerable communities and share effective research-based approaches nationally. Learn more about our research.

FUNDING

This work is a special interest project funded as a competitive supplement grant (SIP14-022) by the Centers for Disease Control and Prevention to the Illinois Prevention Research Center (under Cooperative Grant No. U48-DP005010), which is administered by the Institute for Health Research and Policy of the University of Illinois at Chicago (UIC).