PDF(Pubmed)
Abstract：
Cervical cancer remains the leading cause of female cancer deaths in sub-Saharan Africa. This is despite cervical cancer being both preventable and curable if detected early and treated adequately. This paper reports on a series of action-research \'cycles\' designed to progressively integrate a comprehensive, task-shifted, point-of-care, prevention program in a community-based public health facility in Uganda. The work has been undertaken through a UK-Ugandan Health Partnership coordinated by Knowledge for Change, a UK-registered Charity. The intervention demonstrates the effectiveness of task-shifting responsibility to Community Health Workers combined with the use of Geographic Information Systems to strategically guide health awareness-raising and the deployment of medical devices supporting respectful and sustainable point-of-care screen-and-treat services. The integration of this with public human immunodeficiency virus services demonstrates the ability to engage hard-to-reach \'key populations\' at greatest risk of cervical cancer. The findings also demonstrate the impact of external influences including the Results Based Financing approach, adopted by many foreign Non-Governmental Organizations. The model presents opportunities for policy transfer to other areas of health promotion and prevention with important lessons for international Health partnership engagement. The paper concludes by outlining plans for a subsequent action-research cycle embracing and evaluating the potential of Artificial Intelligence to enhance service efficacy.
摘要：
宫颈癌仍然是撒哈拉以南非洲女性癌症死亡的主要原因。尽管宫颈癌是可以预防和治愈的，如果早期发现和充分治疗。本文报告了一系列行动研究“周期”，旨在逐步整合一个全面的、任务转移，即时护理，乌干达以社区为基础的公共卫生设施的预防计划。这项工作是通过由知识促进变革协调的英国-乌干达卫生伙伴关系开展的，英国注册的慈善机构。该干预措施证明了将责任转移给社区卫生工作者的有效性，并结合了地理信息系统的使用，以战略性地指导健康意识的提高和医疗设备的部署，以支持尊重和可持续的现场护理筛查和治疗服务。将其与公共人类免疫缺陷病毒服务相结合表明，有能力使难以接触的“关键人群”处于宫颈癌的最大风险。调查结果还证明了外部影响的影响，包括基于结果的融资方法，被许多外国非政府组织采用。该模型提供了将政策转移到其他健康促进和预防领域的机会，并为国际卫生伙伴关系的参与提供了重要的经验教训。本文最后概述了后续行动研究周期的计划，包括和评估人工智能的潜力，以提高服务效率。
