Lee Jieying, Ismail-Pratt Ida, Machalek Dorothy A, Kumarasamy Suresh, Garland Suzanne M
Asia Pacific HPV Coalition.
The Obstetrics & Gynaecology Centre, Mount Elizabeth Novena Specialist Centre, 38 Irrawaddy Road, Singapore 329563.
Prev Med Rep. 2023 Jun 29;35:102291. doi: 10.1016/j.pmedr.2023.102291. eCollection 2023 Oct.
The COVID-19 pandemic has exacerbated the existing challenges to achieving the WHO target of eliminating cervical cancer as a public health problem by working towards the target of fewer than four cases per 100 000 women. We reviewed the literature to identify potential recovery strategies to support cervical cancer prevention programs in lower-and middle-income countries (LMICs) following COVID-19 disruptions and the extent to which strategies have been implemented. Utilising the WHO health systems framework, we mapped these recovery strategies against the six building blocks to examine their reach across the health system. Most recovery strategies were focused on service delivery, while leadership and governance played a pivotal role in the continuity of cervical cancer prevention programs during the pandemic. Leadership and governance were the drivers for outcomes in the building blocks of health information systems, financing and critical support in operationalising service delivery strategies. In the aftermath of the COVID-19 pandemic with strained health resources and economies, stakeholders would significantly influence the coverage and sustainability of cervical cancer prevention programs. The support from multisectoral stakeholders would accelerate the recovery of cervical cancer prevention programs. To achieve the WHO target by 2030, we call for future studies to understand the barriers and facilitators from the perspectives of stakeholders in order to support the decision-making processes and information required to implement recovery strategies in LMICs.
新冠疫情加剧了实现世界卫生组织（WHO）将宫颈癌作为一个公共卫生问题予以消除这一目标所面临的现有挑战，该目标是努力使每10万名女性中的病例数少于4例。我们查阅了文献，以确定在新冠疫情造成破坏后，支持低收入和中等收入国家（LMICs）宫颈癌预防项目的潜在恢复策略，以及这些策略的实施程度。利用WHO的卫生系统框架，我们将这些恢复策略与六个组成部分进行了映射，以考察它们在整个卫生系统中的覆盖范围。大多数恢复策略都集中在服务提供上，而领导力和治理在疫情期间宫颈癌预防项目的连续性方面发挥了关键作用。领导力和治理是卫生信息系统、融资以及实施服务提供策略所需关键支持等组成部分取得成果的驱动因素。在新冠疫情导致卫生资源紧张和经济受创之后，利益相关者将对宫颈癌预防项目的覆盖范围和可持续性产生重大影响。多部门利益相关者的支持将加速宫颈癌预防项目的恢复。为了在2030年实现WHO的目标，我们呼吁未来开展研究，从利益相关者的角度了解障碍和促进因素，以支持低收入和中等收入国家实施恢复策略所需的决策过程和信息。
