Empowering Prevention of Cervical Cancer: Women-inspired Strategies for Health (WISH) (2021-2022)

Background 

Worldwide, more than one billion women face sexual and reproductive healthcare gaps with profound consequences to themselves, their families and their communities. Cervical cancer – a completely preventable disease – exemplifies this crisis. Over 500,000 women will get cervical cancer each year, and 1.5 million women will die prematurely over the next five years. 

Screening for cervical cancer in many low- and middle-income countries is as low as two to ten percent. Many women lack access to screening as well as knowledge of prevention and treatment. Far too many women suffer from stigma and shame. 

Global cervical cancer elimination requires a bridge between existing initiatives and the most vulnerable women who need solutions today, especially women past the age of effective vaccination. Women-inspired Strategies for Health (WISH) debunks traditional approaches in which women leave home to have archaic, intimidating medical tools used on them for screening. Instead, WISH equips women with the technology and confidence to have control over their bodies and their health. 

Project Description 

The overall goal of this project is to reduce disparities in access to screening and treatment among low-income women in Peru. The project team will conduct evaluations of key implementation factors for long-term sustainability and scaling of the WISH model (cost-effectiveness, policymaking, community awareness/storytelling) for cervical cancer screening and treatment in Cajamarca, Peru. 

The WISH model involves equipping primary health facilities with technologies for cervical cancer prevention and treatment at the accessible community level. These include HPV self-sampling (screening), Pocket colposcopy (diagnosis) and thermocoagulator (treatment). The model also involves building health system capacity by training women to become community health workers within their communities and facilitating peer-to-peer mentoring and storytelling for education and destigmatization of reproductive health.

The team will have three focus areas and distinct goals: 

  1. Conduct a microcosting analysis of the WISH model in Cajamarca to inform the regional health directorate of the cost savings compared with current practices and recommended national and international guidelines
  2. Use the economic evaluation to inform a policy report recommending a protocol and guidelines for cervical cancer prevention and treatment in the region, to be presented to the regional health authorities
  3. Work with the community women trained as part of the model to optimize their peer mentoring practices and ensure community engagement in efforts that will inform policy change and payment reform. 

Learn more about this project team by viewing the team's video.

Anticipated Outputs

Archive of women’s stories; costing model; decision model; policy recommendations

Student Opportunities

Ideally, this team will be comprised of 3 graduate students and 6 undergraduates. Interested students will most likely be from STEM, social innovation, social justice, history, storytelling and global health backgrounds, with a desire to impact the global health crisis around cervical cancer. Spanish language proficiency will be especially helpful to the team. 

The project will include weekly seminar-style meetings that will provide a framework for implementing the model.

Students will work in three subteams: 

  • Storytelling: Spanish is necessary. Experience in humanities research projects helpful, as is generating evidence-based interview guides, or oral history. The key, however, is simply to be curious about what drives other people to make the decisions they do.
  • Costing: Experience working in economic evaluation, quantitative research experience, experience analyzing large dataset
  • Policy: Experience working with policymakers at the regional or national level in any capacity, experience working in health policy, experience generating formal reports for high-level policymakers and key decision-makers

Each subteam will meet weekly, and all teams will meet together biweekly to share key updates. Each subteam is expected to have 3 members (1 graduate student mentoring a group of 2 undergraduate students).

In Fall 2021, team meetings (for both the full team and subteams) will be held on Tuesdays from 4:30-6:00 p.m.

Students will spend the first half of the fall semester dedicated to understanding the background on cervical cancer and global health disparities, technological developments to democratize access to care (particularly access to screening), and health care systems and challenges in Peru. Students will also learn from experts on the team about oral history, cost effectiveness analysis and policy analysis. This will create the foundation for the creation of tools in the spring semester including storytelling methodologies, stakeholder interviews and time-motion analysis for costing. All students will learn cultural competency and complete all of the essential ethics and regulatory trainings to perform work in Peru, as well as learn how to work effectively in teams.

Libby Dotson will serve as project manager. 

The optional Summer 2021 component will last up to 6 weeks and be dedicated to implementing these tools in Cajamarca, Peru. Selected team members can expect to travel to Peru during the optional Summer 2022 component to work directly with key stakeholders in an intensive research practicum.

Timing

Summer 2021 – Spring 2022 

  • Summer 2021 (optional): Complete requisite training modules; complete required human subjects research training, Community Engagement Training and general laboratory safety training; subset of continuing students from 2020-2021 team to work in a 6-week mentored internship 
  • Fall 2021: Overview of work completed in Year 1 of the project including review of budget-impact analysis protocol, data inputs, analysis and report; review of policy analysis of provider payment and task-shifting considerations; review of storytelling methodologies and field-kit
  • Spring 2022: Development of qualitative instruments and methodologies for costing, policy and oral history; literature review; invitation of external speakers who will provide case studies and initial interviews of key stakeholders remotely
  • Summer 2022 (optional): Virtual or in-person field visits and interviews in Peru

Crediting 

Academic credit available for fall and spring semesters; summer funding available

See earlier related team, Empowering Prevention of Cervical Cancer: Women-inspired Strategies for Health (WISH) (2020-2021).

 

Image: Bass Connections team with HOPE Ladies in Peru, March 2020, courtesy of Center for Global Women's Health Technologies

Bass Connections team with HOPE Ladies in Peru, March 2020

Team Leaders

  • Wesley Hogan, Franklin Humanities Institute
  • Nimmi Ramanujam, Pratt School of Engineering-Biomedical Engineering

/yfaculty/staff Team Members

  • Libby Dotson, Pratt School of Engineering-Biomedical Engineering
  • Patricia Garcia, Universidad Peruana Cayetano Heredia
  • Andrea Thoumi, Margolis Center for Health Policy

/zcommunity Team Members

  • Universidad Peruana Cayetano Heredia
  • HOPE Initiative