1. Division of Reproductive Health Scaling up cervical cancer prevention and treatment in Kenya DR Nakato Jumba DRH CERVICAL CANCER PARTNER FORUM, ELDORET 10 TH AUGUST 2012

2. Division of Reproductive Health Outline DRH mandate Background / Introduction Current situation Country plans Achievements Challenges

3. Division of Reproductive Health DRH mandate Policy formulation and development Coordination of stakeholders Development of guidelines Monitoring and evaluation DRH and Cervical Cancer DRH is the secretariat for the National CECAP program CECAP housed under the RT Cancer Program

4. Division of Reproductive Health Background /Introduction Cervical cancer is the second most common cancer in Kenya Its the most common cause of cancer related deaths in Kenya Oncogenic HPV prevalence in general population is high- 60.9% Most clients present late in the disease ( Stage 3 and above) Extremely high case fatality rate

5. Division of Reproductive Health 5 Situation analysis Total population (2009): 38.6 million Women at Risk for CA Cx ( >15 yrs): 10.6 million Annual no of cervical cancer cases: 2454 Annual number of cervical cancer deaths: 1676 Projected new Cervical cancer cases 2025: 4261 Screening coverage women 18 -69 yrs- 3.2% Kenya NAIROBI Equator Kenya Census report 2009; Globocan – IARC, 2008

6. Division of Reproductive Health

8. Challenges - 1 Asymptomatic until advanced- This hampers visibility and advocacy efforts Primarily affects women – success of interventions limited due to gender imbalances, cultural practices, women’s empowerment etc Health systems – poor infrastructure, poor road transport and communication, inadequate commodities, supplies and equipment; limited availability of diagnosis and treatment for overt cancers

9. Division of Reproductive Health Challenges -2 Financing – minimal financial support for CECAP Human Resources- numbers, distribution, competencies HMIS- poor data management systems Governance: Two Ministries of Health; Low prioritisation in health agenda

10. Division of Reproductive Health Achievements National strategy, guidelines, M&E tools have been developed Quarterly RT cancer TWG meetings National TOTs developed M&E system being rolled out and key indicators to be incorporated into DHIS Regular supportive supervision being implemented Equipment for Dysplasia treatment being procured Advocacy being scaled up

11. Division of Reproductive Health Kenya CECAP Documents

12. Division of Reproductive Health Achievements -2 Awareness at ministerial level Several parliamentary papers have been presented CECAP on of the 3 main areas of focus for DFH in AOP 7 CECAP included as budget line item in national budget fy 2011/2012 HPV introduction planning meetings in process

13. Division of Reproductive Health Achievements -3 Systems strengthening Procurement of cryotherapy equipment – –National budget – 75 –Jhpiego-50+ –GF rd 10 – 50 –Pathfinder- 30+ –CDC / ICAP- Capacity strengthening –TOTs –Service provider trainings

14. Division of Reproductive Health Resource mobilisation Slowly realising more investment in CECAP GOK USAID CDC Global fund BMF- under Tupange project Exploring NHIF to include in minimum service package

15. Division of Reproductive Health Achievements -4 Service Delivery Integration in routine service delivery Integration into outreach services Integration into HIV/ AIDS services Integration into world health days

16. Division of Reproductive Health Next Steps Scale up Advocacy and awareness creation Scale up Service provider trainings Procurement of additional treatment equipment Increase service coverage to all level 3 facilities and above Finalize and disseminate sector documents Application for HPV vaccine for girls 9- 13 years Scale up resource mobilization strategies Scale up operations research

17. Division of Reproductive Health Conclusion Let us strengthen partnerships to reposition and scale up cervical cancer prevention and control

18. Division of Reproductive Health