Arrossi Silvina, Paolino Melisa, Laudi Rosa, Thouyaret Laura
Centro de Estudios de Estado y Sociedad/Consejo Nacional de Investigaciones Científicas y Técnicas, Sánchez de Bustamante 27, Buenos Aires 1193, Argentina.
Hospital Ramos Mejía, Urquiza 609, Buenos Aires 1221, Argentina.
Ecancermedicalscience. 2021 Mar 4;15:1199. doi: 10.3332/ecancer.2021.1199. eCollection 2021.
The Jujuy Demonstration Project (JDP) was a project carried out over the course of 4 years (2011-2014) to develop, implement and evaluate the programmatic components of a Human Papilloma Virus (HPV)-based screening programme in Argentina. The aim of this paper is to present a qualitative evaluation of the context and implementation process of the JDP.
We used an adaptation of the Health System Framework (HSF), which includes interconnected contextual factors that are considered key drivers for successful health interventions. We reviewed secondary documents, which included scientific reports, norms and regulations, information sheets, power point presentations and manuals and recommendations published by the National Programme for Cervical Cancer Prevention. We also carried out semi-structured interviews with key informants to explore their views about technology acceptability.
Key components of the JDP implementation process were: a high level of political support and consensus among stakeholders, the demonstrated effectiveness of the technology and its acceptability by health authorities and providers, the funding of tests and diagnosis/treatment services, the implementation of an information system for monitoring and evaluation and the reorganisation of the network of screening, diagnosis and treatment services.
This analysis examines the policy context in which the JDP was implemented and the system components that were key for the demonstrated effectiveness of the strategy. Such analyses provide useful insights into core components of HPV testing implementation that are needed to guarantee its potential effectiveness to reduce cervical cancer incidence and mortality.
胡胡伊示范项目（JDP）是一项历时4年（2011 - 2014年）开展的项目，旨在开发、实施和评估阿根廷基于人乳头瘤病毒（HPV）的筛查项目的各个项目组成部分。本文的目的是对JDP的背景和实施过程进行定性评估。
我们采用了卫生系统框架（HSF）的改编版，该框架包括相互关联的背景因素，这些因素被认为是成功的卫生干预措施的关键驱动因素。我们查阅了二手文件，包括科学报告、规范和法规、信息表、幻灯片演示文稿以及国家宫颈癌预防计划发布的手册和建议。我们还对关键信息提供者进行了半结构化访谈，以探讨他们对技术可接受性的看法。
JDP实施过程的关键组成部分包括：利益相关者之间高度的政治支持和共识、技术的已证明有效性及其在卫生当局和提供者中的可接受性、检测以及诊断/治疗服务的资金投入、用于监测和评估的信息系统的实施以及筛查、诊断和治疗服务网络的重组。
本分析审视了JDP实施所处的政策背景以及对该策略已证明的有效性至关重要的系统组成部分。此类分析为HPV检测实施的核心组成部分提供了有用的见解，这些核心组成部分对于保证其降低宫颈癌发病率和死亡率的潜在有效性是必要的。
