220066 Federated States of Micronesia National Breast and Cervical Cancer Standards: Developing & implementing resource appropriate policy

Monday, November 8, 2010

Karen A. Heckert, PhD, MPH, MSW , Department of Family Medicine and Community Health, Pacific CEED, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI
Vita Skilling, DCHMS, DpCH , FSM Department of Health and Social Affairs (DHSA), FSM National Government, Pohnpei, Micronesia
Johnny Hedson, MBBS, MMed(Surg) , Pohnpei Department of Health Services, Pohnpei State, FSM, Pohnpei, Micronesia
Martina Reichhardt, BJRN , Waab Community Health Center, Yap Department of Health, Yap, Micronesia
Hali Robinett, MPH , Pacific Cancer Research Group (formerly NCI's Cancer Information Service), Cancer Research Center of Hawaii, Honolulu, HI
Jeannette Grace Koijane, MPH , Pacific Cancer Research Group, Cancer Research Center of Hawaii, Honolulu, HI
Xner Luther , Pohnpei Department of Health Services, Pohnpei State, FSM, Pohnpei, Micronesia
Lee Buenconsejo-Lum, MD , Department Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawaii, Mililani, HI
Significance: Chronic disease morbidity and mortality in the Pacific Islands exceed US rates, including cancers. The Pacific Center of Excellence in the Elimination of Disparities and the former Cancer Information Service collaborated with the Federated States of Micronesia Department of Health and Social Affairs, the four State Departments of Health Services and Comprehensive Cancer Control Programs (CCC) to develop resource-appropriate National Breast & Cervical Cancer (B&CC) Standards.

Objective: The objectives of the September 2008 technical meeting were to review evidence-based and resource-appropriate sources and draft the B&CC standards for prevention, early detection, diagnosis, treatment, and care to create national policy, improve practice and reduce cancer disparities.

Methods: Thirty-five government and private stakeholders participated in a consensus-driven consultative process. Local senior health professionals were resource persons. The CCC Coordinators presented their Assets' Mapping results, chaired the sessions, and facilitated group discussions.

Results: Draft standards were agreed for ‘core',‘expanded' and ‘desired' levels and endorsed as the first national health policy by the Directors of Health in March 2009.

Discussion/Conclusions: Preparations to implement the new standards began immediately. To increase cervical cancer screening and treatment, 12 clinicians were trained in Visual Inspection with Acetic Acid (VIA) who then trained 20 health assistants in Pohnpei and Yap. The Pohnpei Womens' Advisory Council trained 60 community leaders who outreached in 56 villages. The FSM Ad Hoc Training Committee has developed a national curriculum plan. The Community College is reviewing modules for their associate degree courses. B&CC screening has increased significantly in recent months.

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Other professions or practice related to public health
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Discuss the three levels of standards; ‘core’, ‘expanded’ and ‘desirable’ based on the WHO guidelines for prevention and control of non-communicable diseases. Analyze the value of comprehensive standards of practice across the cancer continuum to address health disparities in the United States Affiliated Pacific Islands (USAPI.)

Keywords: Asian and Pacific Islander, Policy/Policy Development

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Director for the Pacific Center of Excellence in the Elimination of Disparities (Pacific CEED) and collaborate with the former Cancer Information Service, the FSM Department of Health Services and the FSM Comprehensive Cancer Control Programs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.