Hampshire Hospitals NHS Foundation Trust, Basingstoke, United Kingdom.
Kataraka Health Centre, Knowledge for Change (K4C), Fort Portal, Uganda.
Front Public Health. 2023 Jul 28;11:1105559. doi: 10.3389/fpubh.2023.1105559. eCollection 2023.
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.
在撒哈拉以南非洲，宫颈癌仍然是导致女性癌症死亡的主要原因。尽管如果及早发现和充分治疗，宫颈癌是可以预防和治愈的。本文报告了一系列旨在逐步将全面、任务转移、即时护理、预防计划整合到乌干达社区公共卫生机构的行动研究“周期”。这项工作是通过英国-乌干达健康伙伴关系（由知识促进变革协调）进行的，这是一家在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，同时结合使用地理信息系统来战略性地指导提高健康意识，并部署支持尊重和可持续即时护理筛查和治疗服务的医疗设备。将这一措施与公共人类免疫缺陷病毒服务相结合，展示了接触处于宫颈癌高风险的难以接触的“关键人群”的能力。研究结果还表明了外部影响的影响，包括许多外国非政府组织采用的基于成果的融资方法。该模型为向其他健康促进和预防领域转移政策提供了机会，并为国际卫生伙伴关系参与提供了重要经验。本文最后概述了后续行动研究周期的计划，该计划包括拥抱和评估人工智能增强服务效果的潜力。
