REPORT TO SHALOM HEALTH INTERNATIONAL FOLLOWING MR AJAYI’S VISIT TO VINE BRANCH HOSPITAL ON WEDNESDAY 27TH NOVEMBER 2019

Introduction

Following Dr Kolade’s visit to Scarborough Hospital in 2018 in October, a request was made for collaboration with Shalom Health International. This was discussed at the last Shalom Health International AGM by the board of directors. I paid a visit to Vine Branch Hospital in Ibadan on Wednesday 27^th November 2019. The purpose of the visit was to:

1. Meet with the Management and team Team in order to introduce Shalom Health International
2. To ascertain the management’s commitment to more effective cervical cancer screening programme
3. To assess the infrastructures available at the hospital and agree on the best ways for Shalom Health International to support
4. Participate in a postgraduate presentation to raise awareness and educate the Vine Branch.

The Visit: The Gynaecology team namely: Dr Kolade, Dr Bridget Kolade,

Visit to the colposcopy Unit:

In the company of Dr Kolade, Consultant Gynaecologist, we inspected the infrastructures in Vine Branch Hospital. I was impressed by the management’s commitment despite the constraints in cervical cancer screening.

Cervical Cancer Screening: The hospital, although privately funded have been involved in cervical screening albeit on a small scale. Currently screen about two hundred patients per year. Majority of their clients come from the Vine Branch Church women initiative where women in the church have organised campaigns to encourage women in reproductive age group to attend for cervical screening at subsidized rate. (The screening rate in the Teaching Hospital goes for…….., cervical screening was for………..

There thus remain opportunity for Shalom Health International in collaboration in health education, policy influence or intervention to enable uptake of cervical screening. For instance, I want to find out if cervical screening is covered by the NHIS. If so, why are people not attending screening. If not, there is room for advocacy for inclusion of cervical screening in NHIS.

Smear: Currently, cervical smear is carried out using the Ayres spatula. The developed countries had moved from this method because of (high rate of inadequate smear)> An opportunity exists for Shalom Health International therefore to train staff in the use and introduce liquid Based sample. As the UK moved to primary HPV screening, Shalom Health International was successful in securing a number of LBC kits that could be used for training and support local efforts in cervical cancer screening.

Other challenges is the rate of recall. No data was provided for recall of cervical smear.

Colposcopy: Vine Bracnch effort is commendable in that arrangement is made for a visiting consultant colposcopist to carry out colposcopy on abnormal smears and treatment as appropriate. There are willing doctors in Vine Branch Hospital who are willing to be trained in colposcopy and managing of abnormal cervical smears.

Advocacy: This is another area where Vine Branch Hospital has done well given the meagre resources available. The Vine Branch Women have been able to sponsor radio and television jingles to educate the public. Information leaflets were made available in local language and smears offered for free or highly subsidized.

Shalom Health international is willing, resources permitting to work in collaboration with Vine Branch Hospital to support these efforts.

Postgraduate Presentation:

Postgraduate meeting held same day at the Vine Branch Hospital attracted the doctors, nurses and proprietress.

The topics covered:

1. Mr Ajayi: Cervical cancer Screening, our collective responsibility

Plan:

The colposcopy suite needs

1. Arrangement to train colposcopist
2. Training in using liquid based cytology and LLETZ pathology: Dr Olorunda will facilitate
3. Switching from Ayres spatula to cervical brush
4. Training of pathologist in handling liquid based sample and LLETZ specimen: Dr Olorunda will facilitate
5. Procurement of Liquid based cytology sample bottles and brushes: Shalom Hrealth International will procure initial / seek for funds
6. Diathermy loops and roller balls: Shalom Health
7. Follow up Visit in May 2019:

Thanks.

Mr Olukunle Ajayi

Shalom Health International

Nov 2019