Counseling, Informed consent, and Patient Rights in “See and Treat” Program

Outline 1.Pre-screening counseling : explaining the implementation of screening and the objectives) 2.Counseling for negative results 3.Counseling for positive outcome (anticipating the psychological effects and explain management) 4.Counseling Pre cryo-counseling Pre cryo- therapy (anticipating the effects of treatment) 5.Counseling Post cryo-therapy 6.Counseling for Positive cancer (to anticipate the psychological effects and explain of management)

1. Pre-screening counseling (explaining the implementation of screening and the objectives) The client should have information about : - Cervical cancer as a disease and the consequences having it - Risk Factors - The important role of VIA - The consequence if VIA is not done - The alternative treatment if VIA Positive

2. Counseling for negative results If the result of VIA is negative, give her information about the result. And when she need to have next VIA (it depends on the regulation within the country)

3. Counseling for positive outcome (anticipating the psychological effects of patients and explain management) Explain that with positive result of VIA almost 100 % of the women can be treated and cured.

4. Counseling Pre Cryotherapy (anticipating the effects of treatment) All of the client women have their rigth to do or not to do the treatment. (However the provider should motivate the women by explaining the importance and the advantage of treatment) Repeat and explain the procedure Tell her (maybe with the husband about the side effects) - Cramps (like menstruation) - Profuse watery discharge - Blood spotting (mild)  avoid to have intercourse about 3 – 4 weeks

5. Counseling Post Cryotherapy Give her information about self-care at home Tell her in which situation, she should come back to the clinic Avoid to have sexual activity (intercourse) or use a condom about 4 weeks Remind her to come for follow up (one month and 6 months)

6. Counseling for Positive cancer (to anticipate the psychological effects and explain the management) Very important to have empathy and support and inform her and if possible her family about further procedure and treatment

Patient’s Right Confidentiality Privacy To know the result Give time to decide if she agrees with further treatment, if needed Information about the treatment, the risks, the benefits Client Consent to treat her Is it needed refer to other complete facilities

Take Home Messages Women who will be involved should be well informed to understand the goal of the program Giving well-understood and persuasive approach will lead the women to feel safe and follow the proposed treatment if needed without worry or fear.