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Promoting evidence-
Introduction
Every year in Vietnam, an estimated 150,000 new cancer cases are detected, with a projection of 200,000 cases per year by 2010. About 80% of cancer cases in Vietnam are identified only at advanced stages with little hope of cure. However, many of these cancers could have been prevented or detected early and treated successfully with lower cost to society in financial terms and lives lost. The large number of late stage cancer patients reflects a considerable need for appropriate preventive measures and palliative care that is not currently being met in Vietnam.
The Vietnamese Government has recently added a National Cancer Control Project (NCCP)
into its National Health Target Programs for 2006-
The purpose of this project is to support the NCCP through improving public awareness of the risk factors and prevention measures for major preventable cancers, supporting policy changes that will reduce risk of cancer at the population level, increasing the availability and accessibility of the public and grassroots health workers to information on early signs of cancer and the referral system, and improving accessibility to appropriate pain control and quality palliative care for advanced cancer patients.
Objectives
The ultimate goal of this four year project is to reduce incidence and mortality from cancer and to improve quality of life for cancer victims.
The specific objectives of the project are:
- Improving public awareness of the risk factors and prevention measures for major cancers in order to promote and encourage people to adopt healthy lifestyles to reduce cancer risk;
- Create impetus for policy changes that enable the public to adopt and maintain a healthier lifestyle, particularly more physical activity, consumption of healthier foods, and avoidance of tobacco use in order to reduce the risk of cancers at the population level;
- Increasing public awareness of early signs of common cancers and increase accessibility to information about facilities capable of providing appropriate diagnostic and treatment services in order to improve the timeliness of diagnosis and treatment of treatable forms of cancer;
- Improving public and policy maker recognition of the need of cancer patients in appropriate pain control and palliative care and improve the social support for advanced cancer patients to reduce suffering.
Results and Impact
To date, the project team has achieved the following results:
Progress towards achieving the first objective was achieved through the design and initiation of a series of activities and outputs that focused on research and surveys. These include the following:
- Review of cancer prevention policies: The final report on the review of existing policy documents and best practices related to cancer prevention was produced in early 2011. Major gaps were identified relevant to alcohol control, tobacco control, physical activity promotion, nutrition and food safety, and the national cancer control program.
- The occupational cancer prevention policy review: The final report was completed
in late 2010. The main findings of this review reveal major gaps in the list of
carcinogens, the list of recognized occupational diseases, in death registration
of occupational diseases including occupational cancers, in supervision guidelines
and mechanism for partnership between the local health sector and enterprise health
sector to provide health care to workers, and in regulation on health check-
up and occupational disease assessment for workers. - The Palliative care situation analysis: The final report was completed in late 2010.
The main findings of the analysis reveal the gaps in detailed instructions on providing
palliative care at each level of health services, limited palliative care unit for
cancer patients at both the central and provincial level, palliative care provided
with less attention to psychosocial support and end-
of- life care, and dissatisfaction among cancer patients and family care givers received palliative care. - The Audience formative research: The final report was completed in early October
2010. The main findings of this research include limited awareness of cancer risk
factors, prevention measures, and common cancers, low number of people recognized
the warning signs of cancer, very few people knew about hepatitis -
B vaccine and HPV vaccine, low number of people knew about cervical, stomach, and colon and rectal cancers as common cancers in Viet Nam, insufficient knowledge about cancer prevention among primary health workers; and weak coordination between cancer communication program and related programs at the district and commune levels. - Establishing baseline data and provision of small grants for researchers: The existing website on cancer of the NCCP at www.ungbuou.vn has been upgraded and revised under the agreement between HBV and the NCCP for general public education and appropriate contents. Helpful articles on cancer were collected and revised with the purpose of ensuring the content was both scientifically correct and easily understandable for the general population. Regular maintenance has been implemented to update this webpage to present its health communicative contents for general population and health professionals.
Progress towards the second objective has been achieved through the implementation of a series of activities and outputs that focused on communication and education. These include following:
Recommendations
Project profile
Key Partner: HealthBridge Vietnam
Location: Vietnam
Donor: The Atlantic Philanthropies
Duration: 2009 -
Contact person: Le Thi Thu Hien, Project Manager, HealthBridge Vietnam, hienle@healthbridge.org.vn
Reports and Resources
- Development of a comprehensive communication plan for cancer prevention: The communication
plan was developed to help NCCP to improve the communication activity in the period
2011-
2015 by providing a comprehensive and evidence- based framework for communication activities. The NCH was also disseminated to other relevant agencies working on communication for cancer prevention and control. - The national campaign on cancer prevention: It will be held on 16th October 2011 (around the Vietnamese Women’s Day). The campaign aims to raise awareness of policy makers, health professionals and the public (including patients and their relatives) on protecting women from cancer risk factors (especially passive smoking). This is a joint funded activity of the National Cancer Hospital (NCH), WHO Vietnam and HealthBridge.
- A series of TV talk shows on the topic of ‘Cancers can be prevented’ and ‘Smoking and cancer’, TV reportages was produced and aired on the National TV channels (VTV1, O2TV). The products introduced essential knowledge for the audiences about risk factors of cancer and opportunities for early prevention of this disease.
- A drama on preventing cancer risk factors is being developed and expected to completed in October 2011. This drama aims to raise public awareness on cancer prevention with the key message of “Cancer can be prevented by reducing current risks”. The drama is plan to be aired on National TV channels and any communication events and disseminated widely to cancer hospitals, relevant health facilities.
In light of the progress made to date, various research studies have identified policy
gaps, health problems, and offered useful recommendations for new policies’ development;
identified the needs of the health problem, methods of reaching the intended audiences
and the barriers need to be overcome. Factsheets and policy briefs are being developed
with the purpose of distributing among policy makers and program managers, so developed
policies will be evidence-
Progress towards the third objective has been achieved through the implementation of a series of activities and outputs that focused on social mobilization and advocacy. These include following:
- Linkage amongst stakeholders has been established through the participation of staff
working in other NCD program, such as NCH, VINACOSH, Viet Nam Food Administration,
NCD units, and others in the Strategic Health Communication Workshop. A network
of staff interested in cancer prevention from different government and non-
government organizations has also been established. - Fund joint health promotion activities with the participation of NCD groups: HealthBridge Canada has mobilized fund from NCH and WHO Vietnam for implementing project activities. In the year 2011, two joint activities is going to be implemented as the National campaign on women cancer control and the research on cancer in Vietnam.
As a result of these activities, the participation of and collaboration among various
stakeholders, including those from the Vietnamese government, non-
Progress towards the fourth objective has been achieved through the implementation of a number of activities and outputs that focused on human resource capacity building. These include following:
- HealthBridge collaborated with the Center for Community Health Research and Development,
and Dr. Benjamin Lozare, an international communication expert from the Center for
Communication Program at Johns Hopkins Bloomberg School of Public Health to organize
two Strategic Health Communication Training Workshops in 2010 and 2011. More than
30 managers and staffs related to cancer prevention in Viet Nam were invited to the
training. In addition to the positive post-
test results, verbal feedbacks from attendees indicated that they really enjoyed and gained valuable knowledge and skills from participation in this training. - HealthBridge collaborated NCH and WHO in the training course on cancer registration as requested by NCH. HealthBridge provided technical inputs to the training program and invited Dr. Parkin to be the lecturer for this training. The 32 participants were staff working on cancer registries in nine provinces/cities, including Hanoi, Thai Nguyen, Hai Phong, Thanh Hoa, Da Nang, Thua Thien Hue, HCMC, Kien Giang, and Can Tho. The training provided an opportunity for staff to share experiences in cancer registration, and to learn about registry methods, data quality control, and the roles of cancer registries in cancer control.
For more information on results achieved to date, please see the most recent semi-
- Developing and maintaining a network/partnership on cancer prevention in particular and on NCD prevention in general is crucial for mobilizing resources and expertise for better project outcomes and to ensure that the project’s activities are relevant and useful.
- Sharing the goal and objectives of the project with partners and keeping them updated with project progress facilitates the identification of opportunities for specific collaboration and for additional resources. The project team kept the NCD team updated about project progress, and this convinced them to identify additional funds for a campaign and a research.
- Involving the national cancer program and cancer hospitals in project activities
required the project team to be always proactive and flexible as governmental organization
staff are often engaged fully in their routine work and cannot dedicate enough time
for additional project work. The HBV staff often utilized different communication
methods, in particular face-
to face meetings, to have consultations with the leaders/managers to persuade them to provide staff time to perform project tasks.
- The Government should create enabling policy environment supporting for cancer control activity in the country.
- Cancer communication should focus on preventing risk factors, early detection and palliative care for cancer patients.
- The NCCP should apply the developed communication plan with highest attention to effectively achieve its goal and objectives.