Contribution to the Project on Cervical Cancer Prevention in Moldova

Project completed

In Moldova, the cervical cancer incidence and mortality of women continues to be high due to very high proportion of late stage diagnoses. An integrated approach to cervical cancer prevention and control combining vaccination and regular cervical screening has the potential to reduce cervical cancer deaths by at least 80%. The project aims at reducing incidence and mortality due to cervical cancer through better access to and use of cost-effective and quality services within organized cervical cancer prevention program.

Country/region Topic Period Budget
Moldova
Health
Primary health care
01.07.2017 - 30.06.2022
CHF  600’000
Background

In Moldova, cancer mortality is high, accounting for 14% of all deaths. This is especially true for cervical cancer incidence (15.6 per 100'000 population) and mortality (8.1/100'000). Recent assessments (2014, 2016) concluded that cervical screening is conducted opportunistically. The screening's impact on cervical cancer rates is low, as it is implemented without proper staff training, standardization of procedures, integrated delivery of health services, effective patient management, or quality assurance.
In order to better organise the cervical screening program, the Ministry of Health, jointly with the National Health Insurance Company and with support from UNFPA, developed the 2016-2018 National Action Plan for the Implementation of Cervical Screening. The plan specifies the revision of the regulatory framework, the creation of a Cervical Screening Coordination Unit, the design and implementation of the Cervical Screening Registry, as well as a continuous strengthening of primary health care and speciaiized services' capacities. The cervical screening is already specified as a responsibility of primary health care centres staff, and the follow-up of screen-positive women has been approved to be undertaken in all 2nd level hospitals.

Objectives

The incidence and mortality of Moldovan women attributable to cervical cancer is reduced.

Target groups

Family doctors, rnedical assistants/nurses, gynaecologists, and pathologists from different healthcare institutions, including from Transnistria region, as well as representatives of Ministry of Health, National Health Insurance Company, National Centre of Health Management, and medical education institutions responsible for undergraduate, graduate, postgraduate, and continuing professional education. Final project beneficiaries are all women and girls from Moldovan population, including 761'504 women aged 25-61 years (target population eligible for cervical screening), and 14'387 girls aged 10 years (target population for HPV vaccination).

Medium-term outcomes
  • Women and adolescent girls have better access to quality cervical screening services and HPV (Human Papillomavirus) vaccination
  • Women and adolescent girls have increased awareness and knowledge of the benefit of cervical screening and HPV vaccination
Results

Expected results:  

  • National normative framework to enable the effective Operation of cervical cancer prevention services is reviewed and updated
  • National quality assurance guidelines and standards for cervical screening services are revised, approved and used
  • Technical capacity of healthcare facilities involved in cervical screening is strengthened in compliance with international evidence-based standards
  • Knowledge and skills of health personnel to provide quality cervical screening services and HPV vaccination are improved
  • National coordination, monitoring and evaluation of cervical screening, based on reliable data, are strengthened
  • Comprehensive approach is applied to increase awareness and knowledge of women and adolescent girls and improve their healthcare seeking behavior and demand for cervical screening and HPV vaccination


Results from previous phases:  

The collaboration between SDC and UNFPA started in 2016, with a project on strengthening cervical screening capacities of primary health care providers. With SDC support, 406 primary health care professionals (69 family doctors and 337 nurses) selected from 19 districts, have been trained. Previously, UNFPA facilitated the training of 12 Moldovan prirnary health care specialists as trainers. Also, several other specialists (cytologists, pathologists and gynaecologists) have benefited from short trainings (1-3 months) in international centres.


Directorate/federal office responsible SDC
Credit area Swiss cooperation with Eastern Europe
Project partners Contract partner
United Nations Organization (UNO)
  • United Nations Population Fund


Coordination with other projects and actors

The project will receive additional support from WHO/GAVI, International Association for Cervical cancer prevention and Ministry of Health. lt will be implemented in synergy with ongoing SDC supported projects that integrate health and social care (Healthy Life, Healthy Generation, Mental Health projects).
The project will also coordinate its efforts with other relevant health programs and projects supported by WHO, World Bank, GIZ, and Norway aiming at strengthening primary health care, promoting healthy lifestyles, and preventing non-communicable diseases.

Budget Current phase Swiss budget CHF    600’000 Swiss disbursement to date CHF    590’000
Project phases

Phase 1 01.07.2017 - 30.06.2022   (Completed)