Elimination of cervical cancer and related morbidity and mortality in the context of Universal Health Coverage in Bhutan

Universal Health Coverage (UHC) means that all individuals and communities receive the full spectrum of essential, quality health services without suffering financial hardship. Chugai is supporting the Bhutan Cervical Cancer Eradication Project to contribute to the further advancement of UHC in Bhutan from 2021. Support mobilized from Chugai Pharmaceutical company, is used to complement the implementation of the National Flagship cancer screening program led by the Ministry of Health, Bhutan. 

• Background

  Building on the success of the initial UNFPA-Chugai partnership (2021-2023) ‘Supporting the Project for

  Eliminating Cervical Cancer Toward the Promotion of UHC in Bhutan’, the second phase (2024-2026) expands support to the Ministry of Health to accelerate cervical cancer elimination with focus on improving the quality of screening and treatment through support to develop and institute service guidelines, develop capacity of health care providers specifically cytotechnicians, pathologists on improving the diagnostic accuracy, nurses involved in screening and treatment, medical doctors on improved diagnostics/treatments, and strengthening the quality control and reporting system and research.

  The overall objective of the 2nd phase is to empower the Ministry of Health to effectively implement the national cervical cancer elimination strategy by improving the capacity of healthcare providers in three key areas: (1) Screening and Early Detection (2) Diagnosis and Treatment (3) Quality Assurance and Research.

  By strengthening the healthcare system's capacity, this partnership aims to significantly improve cervical cancer prevention and treatment in Bhutan.
  
  
  

• Programme for 2024

  Major activities included developing of the national treatment guidelines specifically the colposcopy and LEEP guideline; improving the quality control and quality assurance of cytopathology and histopathology diagnostic services through service standard development and capacity development, implementation of post flagship sustainable program for cervical cancer program, review and update of the national screening guidelines and standards, and capacity development in cervical cancer screening, early diagnosis and treatment services.
  
  
  

• Key Activities and Results

  The health flagship program utilized effectively reached almost 90% of its target population, successfully lowering the incidence of cervical, breast, and stomach cancers. Particularly now the screening services have been integrated into the routine health services, and women and girls can avail the screening services from the health facilities on routine basis.This achievement created a strong foundation for future cancer control efforts.
  
  To maintain this momentum, the Ministry of Health recognized the need to address challenges such as shortage of skilled human resources, inadequate screening and treatment service quality, equipment deficiencies and data management challenges. To overcome these challenges, the following four main activities which are ①The National Post Flagship Action Plan　②National Guideline for Colposcopy and LEEP　③Cytotechnology and Histotechnology Laboratory Manual　④ Capacity development of health care providers have been implemented in 2024.

Photo 1-4 Credit: JDWNRH, NCCP, Ministry of Health in Bhutan

• Description 

  Photo 1: The team represented by gynecologist, pathologist, medical surgeon, radiologist, palliative care workers, cancer registry focal and nurses engaged in development of the Post-Flagship Action Plan

  Photo 2: The team was composed of pathologist, gynecologist, gyne oncologist and colposcopy nurse and community health unit nurses.

  Photo 3: Third from the left Dr. Biren Pradhan, head of the pathology department at JDWNRH was leading the team.

  Photo 4: Dr. Namkha Dorji leading the training on of prevention of ureteric and bladder injuries during the

  cervical cancer surgeries, Phuntsholing General hospital, Chukha

Reference

1. Supporting the Project for Eliminating Cervical Cancer Toward the Promotion of UHC in Bhutan ～　Activity Report in 2022 to 2023　～

https://www.chugai-pharm.co.jp/english/sustainability/activity/detail/20240418000000_131.html