Introduction
Cervical cancer is the second-leading cause of cancer death in the Federal Democratic Republic of Ethiopia. There are over 7,000 cases of cervical cancer and 4,732 deaths due to cervical cancer each year in Ethiopia.[1] In 2015, Ethiopia became the fourth Pink Ribbon Red Ribbon partner country. Pink Ribbon Red Ribbon, with a grant from GlaxoSmithKline, began a program to provide screening and treatment for cervical pre-cancer. Additional funding from the Bristol-Myers Squibb Foundation has complemented these activities, and the US President’s Plan for AIDS Relief (PEPFAR) contributed funding in 2017 to scale up these activities with a focus on HIV-positive women, by using PEPFAR-built infrastructure. PRRR is supporting the Government of Ethiopia to open 59 “See-and-Treat” sites to reach a larger portion of the population in the two most populous Regions and Addis Ababa with cervical and breast cancer screening services, supported the development of the first National Cancer Control Plan that was launched in 2015, and has placed a Technical Advisor for a three-year period to support the Federal Ministry of Health to implement the plan.
The Government of Ethiopia has shown strong leadership through the Federal Ministry of Health and in the First Lady, who co-chairs the National Steering Committee for Cancer Control. The Government is using its own funds to open up to 1,500 “See-and-Treat” sites and aims to reach every district of the country, and is also establishing and equipping five regional centers of excellence for cancer control over a five year-period. An evaluation of the GSK/PRRR funded project will provide valuable lessons learned for the FMoH to scale up and sustain the national cervical cancer control program.
Objectives
This evaluation will determine the progress made in Ethiopia in secondary prevention for cervical cancer through the GSK/Pink Ribbon Red Ribbon project. The focus will be on the screening and treatment program, but will also address the cross-cutting issues of governance, policy, resource-mobilization, program-management, and sustainability that define the policy environment in which the programmatic activities take place. The evaluation will review all the levels of the Ethiopian health system (District, , Regional, and National), in the Oromia Region, Southern Nations, Nationalities and Peoples Region (SNNPR), and in Addis Ababa, to achieve the following objectives:
Ethical Considerations
The evaluation should be considered part of the FMoH’s routine work, as the immediate outcomes and lessons learned will contribute immensely to the development of the cervical cancer prevention program. The Ministry and the evaluation team will seek consent and obtain approvals from the respective authorities at each level of the Ethiopian health system, as well as from the program beneficiaries interviewed. The interviewers will protect the confidentiality of the respondents by avoiding the use of personally identifying information.
The lessons from the evaluation will also be useful to other countries in sub-Saharan Africa, to facilitate South-South learning for quality-improvement. As noted above, the evaluation team, Ministry of Health, Pink Ribbon Red Ribbon and interested partners will jointly publish the processes, lessons learned and recommendations in a peer-reviewed journal.
Timeline
We propose a 90-day engagement to commence and complete activities. In December 2017, the teams will adapt the data collection tools, obtain ethical approval, and conclude the pre-field activities. Field activities will start in January 2018, with the aim to complete the collection and analysis of the data by the end of February 2018. Report-writing and the dissemination meeting will take place one month after to account for data analysis and report, to be completed by March 1, 2018.
Activity | Timeline | Organization(s) responsible | Notes | ||||||
| Dec | Jan | Feb. | Mar |
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Adapt data collection tools | X |
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| Consultant and Pink Ribbon Red Ribbon | Tools already created by PRRR; to be adapted to Ethiopian context |
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Receive approval from FMoH and notify regions | X |
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| Consultant, MWECS | MWECS will lead the notification and approval process. |
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Field data collection and compilation |
| X | X |
| Consultant |
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Data analysis |
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| X |
| Consultant |
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End of project report |
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| X | X | Consultant |
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Project close out |
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| X | Pink Ribbon Red Ribbon |
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Qualification and consultancy experience of consultant
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