1. GROUP WORK
Working Meeting on Comprehensive Cervical Cancer Prevention and Control in UNFPA
EECARO and ASRO countries
Antalya, Turkey
May 18-20

2. Group work by teams of countries
OBJECTIVE
To identify 4 priority actions to improve existing programmes or
design a new programme (if there is not any cervical cancer
prevention and control programme in the country).
3 STEPS/ GROUP WORK SESSIONS
I) Success stories and challenges****
II) Four priority actions
III) Operationalization of the actions****

3. Group work by teams of countries
1) Use what we learned yesterday
2) Use the Programme Guidance for Countries- English,
French, Russian
3) COMPREHENSIVE programme
4) Pay particular attention to disadvantage groups

4. Group work by teams of countries
Session I: Success stories and challenges
1) ADVOCACY
i)Target groups?
ii) Key messages for each target group?
iii) How can messages be delivered?
iv) How can we mobilize communities?
v) Challenges?
vi) Opportunities?
2) VACCINES
Challenges and opportunities to introduce/sustain HPV vaccination in your
country
3) SCREENING AND TREATMENT
I)Challenges and opportunıtıes to have national population based screening
programmes and early treatment precancerous lesions.
II)Type of screening methodology and treatment modalities than can be
used in the country.

5. Group work by teams of countries
Session I: Success stories and challenges
Albania, BiH, Kosovo, Macedonia,
CHALLENGES OPPORTUNITIES
BiH: Funding
Macedonia: Coverage, proper targetting
Kosovo: no health insuranc at all
All:
-Readiness and willingness of civil
- Lack of data for evidence-based advocacy (lack of quality
society to support the issue
baseline data);
-- RH on the political agenda
- Lacking Cx Ca information system;
-Readiness of UNFPA and donor
- Lack of technical expertise for tailored campaigns,
community to support the issue
- Right timing
-Reginal cooperation /initiative
- Lack of understanding of the community practices
-- The existance of some advocacy
- Lack of BCC targeted campaign approach; Lack of adequate
materials of relevance for the whole
ADVOC comprehensive services
region, with some adaptation (song,
ACY - Values and cultural factors to advocacte for SRH issues
pamphlets..)
- Ad hoc-activities
--Many commonalities that would
- Funding health is not a priority under EU integration
justify sub-regional approach for
processes, amongs other more pressing issues
advocacy and expecting positive
- Political context that interferes with health priorities
raction by the stakeholders
- Grass-roots mobilisation
-Existing advocacy: condom use
-Focus target on women only
promotion as entry point into
-Lack of experience in targetting men: how to target them
advocacy for men
-Lack of evidence, especially for how HPV affects men, to use
as advocacy tool
- Targetting vulnerable groups (ie: Roma)

6. Group work by teams of countries
Session I: Success stories and challenges
Albania, BiH, Kosovo, Macedonia,
CHALLENGES OPPORTUNITIES
-Financial resources
-- Models of integration in the current systems
- Cultural beleifs: the vaccine “encourages girls to
have sex” “encourages promiscuity”
-New vaccine: lacking evidence for the impact
-Duration of vaccine effect: 8 years only -It prevents the infection
-Vaccine only targets girls (lack of understanding: --The region has a good tradition in
VACCINATION why not vaccinate men, as the carriers and effective vaccination
transmitters of HPV) -
-- Unlcear messeges to pass to the parents
- Vaccine not introduces systematicly in the PHS ,
except in Macedonia.

7. Group work by teams of countries
Session I: Success stories and challenges
Albania, BiH, Kosovo, Macedonia,
CHALLENGES OPPORTUNITIES
- Preparedness of the health system
- Existing of a screening pattern may pose a barrier for transforming it into a more
efficient one (PAP test screening) - instead of primary health care systemised
visual inspection as screening method that could be much more effective
-- Functional healht systems
- Demanding logistical and administr. arrangements (repeat visits..)
and relatively good
-Opportunistic screenings mostly in place (gynecologica lcheck up, and as a part of
infrastructure to build upon.
it „maybe‟ HPV check.
(Health insurance covering
-Monitoring and evaluation of efficiency of the programme is still weak
treatment in most countries
-Various stages of developing the clinical protocols for the comprehensive
except Kosovo).
screening and treatment programmes; various stages of financial coverage..
- Good evidence to
- Various levels of functioning of referral systems
demostrate that other
- There are gups in public health system financing of services needed
screening methodologoes
-Human resources an issue for proper PAP smear reading
can work and other
SCREENING - The structure of the health system itself (family medicine; ongoing reforms..) –
programmatic approaches
confusing.
AND -Not enough trained nurses
can work.
TREATMENT -The willingness of civil
-Health information system have gaps : quality of the date an issue, largely health
society to put pressure on the
facility based, not population based register
government to deliver
-Gaps and delays between check ups and follow ups
services for Ca Cx prevention
-Unevean situation relating to clinical protocols and their application and quality
-Opportunity for links
control
between MoHs and CSOs .
-- Situation variable relating to treatment of pre-canot lesions standardissation
-CaCx inclded in wider
- Public health system does not perform HPV DNA testing, only in the private
strategic contexts for RH
sector and in ad-hoc manner
-Similarities in the countries
-Health system not supported by community involvement, is very oriented towards
that favou experience sharing
specialised care
.
-Gynecologists often resistant to empowering nurses more in engaging preventive
activites in primary health care.
--

8. Group work by teams of countries
OBJECTIVE
To identify 4 priority actions to improve existing programmes or
design a new programme (if there is not any cervical cancer
prevention and control programme in the country).
3 STEPS/ GROUP WORK SESSIONS
I) Success stories and challenges****
II) Four priority actions
III) Operationalization of the actions****

9. TEAMS OF COUNTRIES
EECARO ASRO
Kazakhstan
Egypt
Kyrgyzstan
Lebanon
Tajikistan
Syria
Turkmenistan
Uzbekistan
Facilitator: Magdy Khaled
Facilitator: Rita Columbia
Armenia
Algeria
Azerbaijan
Morocco
Georgia
Tunisia
Turkey
Facilitator: Mohammed Lardi
Facilitator: Philip Davies
Moldova
Russia
Ukraine
Facilitator: Tamar Khomasuridze
Albania Regional and global participants join teams
Bosnia and Herzegovina
Kosovo
Macedonia
Facilitator: Tatjana Shikoska

10. Group work by teams of countries
Group work until lunch time (-13:00)
EECARO teams in Ball Room III
ASRO teams in Plaza Room (-3 floor)
PRESENTATIONS AFTER LUNCH (14:00-15:30)
10 MINUTES PER TEAM