LAPO COMMUNITY CAMPAIGN FOR CANCER CONTROL (LAPO-C4) PROJECT

The LAPO-C4 project is aimed at reducing cancer-related deaths by focusing attention on activities that promote prevention and early detection. Prevention will be achieved through education of the populace on the pre-disposing factors, early signs and symptoms to look out for while early detection will be achieved through the provision of mobile screening services and massive drive for regular uptake of cancer screening services.

The LAPO-C4 project services will be delivered by local organisations (CBOs) at the population level. These include targeting community groups- schools, market, religious gatherings, etc. for social mobilisation through IPC, IEC materials, referrals, screening services, etc. for cancer prevention and control. However, State and Federal level advocacy, media campaign, IEC production and facility upgrading for free screening will be carried out by LAPO.

The Project is being implemented in the following states between 2016 and 2018 with the possibility of scale up to more states after two years of implementation:

  •    Abuja - FCT
  •    Lagos
  •    Edo
  •    Rivers and
  •    Imo.

The target population for the project is:

  •       Women for breast and cervical cancer
  •       Men for prostate cancer (men)
  •       Men and women for childhood and liver cancer enlightenment

The Project Strategic Interventionsare:

•      Capacity Building
•      Advocacy– For policy and practice change
•      Inclusion of screening services at PHC level in Nigeria
•      Provision of subsidized Screening at PHC level
•      Provision of subsidized treatment for less privileged women with cancer in Nigeria

List of Community Based Organisations working with LAPO on the LAPOC4 project

S/No

State

Name of CBO

1.     

Lagos

JAKIN NGO

2.     

Edo

Bella Foundation for Child and Maternal Care (Formerly Association for Child Health), Benin City

3.     

Edo

Willi Johnson Foundation, Afuze

4.     

Edo

Partnership For Survival, Ubiaja

5.     

Edo

Initiative for the Development of the Next Generation (NEXTGEN)

6.     

Edo

Rehabilitation Initiative For Counselling And Healthcare (RICH)

7.     

Rivers

Care and Development Centre (CADEC)

8.     

Rivers

Rivers of Hope and Humanitarian Initiative (ROHI)

9.     

Imo

Better Community Life Initiative (BECOLIN)

10.            

Imo

Our Lady of Perpetual Help Initiative (OLPHI)

11.            

Imo

Friends for Community and Youth Development (FECODEO)

12.            

FCT

Women Friendly Initiative (WFI)

13.            

FCT

Yes to Life for women and children

 

HIGHLIGHTS OF LAPO-C4 PROJECT ACTIVITIES

 

1 FLAG OFF RALLY IN BENIN CITY

LAPO-C4 project was kicked off with a rally along major roads (Dawson, Akpakpava and Ring Road) in Benin City on 23rd November 2016. It lasted for about five hours with one hundred and eighty-five (185) participants which included LAPO staff, clients, members of civil society organizations and LAPO CBO partners. The Nigeria Police Force provided security and road safety services during the event. Placards and handbills with different cancer prevention and control messages were distributed freely to spectators as we went. A public enlightenment session was held at the popular King’s Square museum ground. During the session, people asked questions like ‘if my wife has cancer of the breast, would breast sucking help? ’If God knew there was no affordable cure, why did he create the disease?’ ‘Must the breast be cut off?’ Must it be treated outside the country?’ ‘How can one get help or detect it early?’ They all got satisfactory answers and the people acknowledged that the messages were helpful for their daily life as we took attendance and rounded up the activities.  

  • Rally Route and people reached with messages

The take off point was LAPO head office on Dawson Road, Benin City through Akpakpava junction, a walk of about a hundred meters. From Akpakpava through Agbado market to Ring Road was another 150 to 200 meters walk. We walked past a lot of shops mostly owned by male traders, spreading information on cancer prevention and control generally. From Akpakpava to Ring Road, we had general awareness conversations with people, especially at Agbado market area which had more population of women. General cancer messages were disseminated at the Ring Road axis with more of general population comprising market women, male traders, bus drivers, taxi drivers, security personnel and civil servants.

IEC materials distributed by type at the rally

1. The risk of prostate cancer increases with age.
2. Everyman is at risk of developing prostate cancer.
3. Every woman is at risk of breast cancer. Do breast self-examination today.
4. Cancer is a deadly disease, get screened today,
5. Go for regular cancer screening.
6. High number of pregnancy increases risk of cervical cancer.

Conclusion

The flag off rally was a huge success with beautiful weather from the early hours of the morning till the close of the day. One hundred and eighty-five (185) people participated in the rally and distributed awareness fliers along the streets of Benin to enlighten the public about the LAPOC4 project, the danger of cancer and its preventive measures. The rally was well reported in the media with pictures in BusinessDay Newspapers of November 25th, 2016. It is indeed a project to be encouraged. With more hands on deck, we can do better. 

 

2 Inception Training

The LAPO-C4 Inception Training was organised for the CBOs engaged byLAPO towards improving their capacity for quality implementation, evaluation and documentation of project activities. The training was held between Monday, 7th November and Wednesday, 9th November, 2016 to enable the 39 CBO staff (Project Manager, M&E and Account Officers); manage the assigned project tasks and resources for quality implementation of the LAPO-C4 project.

The key training objectives include:

1.    To promote effective linkages between target communities and the facilities to improve accesses to cancer services.
2.    To disseminate effective interpersonal communication of cancer prevention, control and treatment messages among target group
3.    To develop project implementation work plan and cost of proposed activities.
4.    To carry out project M&E at the CBOs level

The CBO participants were trained on project management and cancer control issues such as Project Management, Community Mobilisation in Cancer Projects (Social & Resource Mobilisation), Strategies for sustaining Project Services in target communities, Advocacy Engagement of Stakeholders at Community and Local Government Levels, Project Strategies and Indicators,  Roles and responsibilities of partners, Cancer Management – Prevention, Control, Screening and Treatment, M&E, project account management, CBO workplan development, etc. The pre and post test scores indicated that the training was effective in improving participants’ knowledge and skills relevant to the achievement of the overall objectives of the project. However, it must noted that there were individuals whose performance was consistently low. This has made it imperative for the M&E personnel to identify such individuals for knowledge and skills upgrade in the identified gap areas as project implementation continues.

 

3 DIALOGUE WITH STAKEHOLDERS FOR CANCER CONTROL

Introduction

The dialogue session with cancer control stakeholders in Nigeria was held to introduce the LAPO-C4 project and to collectively identify direction for the project intervention in Nigeria. The event with the theme: War Against Cancer: All Hands on Deck, was held at the Eseiwi Hall of the LAPO Institute in Benin City. Participants at the dialogue session discussed issues in cancer and other non-communicable diseases (NCD), proffered realistic solutions with suggestions on the way forward.  A total of one hundred and sixteen (116) people attended the dialogue session.

Breakdown of Participants

Participants at the event were drawn from the key sectors responsible for cancer control in Nigeria such as the health ministry, the academia, ministry of finance, government agencies, civil society organizations and the media. They include Prof. Michel Ibadin (CMD, UBTH), the Hon. Minister for Health who was ably represented, Dean, School of Medicine, the University of Benin, the National Coordinator of The National Cancer Control Programme, Dr. Ramatu Hassan, the state coordinators of the target States of the Cancer Control Programme (Lagos, Edo, Rivers, Imo and Abuja, the guest speakers, Prof. M. Momoh and Dr. Omokhoa Adeleye of the Department of Community Health, University of Benin/UBTH, Chairperson, Board of Directors, LAPO, Prof. Christiana Okojie, the Executive Director of LAPO, Sabina Idowu-Osehobo, and so on.

Opening

The programme started with an opening prayer, followed by the moderator introducing the distinguished guests. The opening remark was made by the Deputy Chairman of the Medical Advisory Committee (MAC) of the University of Benin Teaching Hospital (UBTH), Prof Afekhide Omoti while the welcome address was delivered by the Founder of LAPO, Dr. Godwin Ehigiamusoe. 

Opening remarks by the Chairman, Prof. Afekhide Omoti

Prof. Afekhide Omoti welcomed the guests, staff, the press and others to the Dialogue Session and praised the initiative and dedication of the founder of LAPO. He noted that it is uncommon to see someone like Dr. Godwin Ehigiamusoe so dedicated to helping the poor and the disadvantaged in various areas especially in the health sector. He said those who are specialists know that cancer is one of the major causes of death in the world but can be prevented through awareness creation and timely detection and therefore solicited for support.

He expressed hope that at the end of the Dialogue Session, we shall be able to make valuable recommendations that will enable government fashion policies that would improve the health sector in Nigeria. He thanked everyone for coming.

Welcome Address by Dr. Godwin Ehigiamusoe

The Founder of LAPO, Dr. Godwin Ehigiamusoe gave the welcome address. He acknowledged the presence of the Honourable Minister of Health who was ably represented by the Chief Medical Director of the University of Benin Teaching Hospital (UBTH), the chairman of the occasion, distinguished guests and LAPO staff members.

Dr. Ehigiamusoe noted that the LAPOC4 project is an initiative funded and coordinated by LAPO to reduce cancer-related death with primary focus on prevention and early detection. The project aligns with the LAPO vision of a healthy society characterized by prosperity, justice and equity. From inception, he said LAPO has been engaged in Community Health Outreach and upgrading of rural health facilities. For examples, between April and September 2012, a total of 3,458 women received LAPO cervical cancer screening services in Benin City and Ekpoma in collaboration with the Edo State Government. 18 of the beneficiaries were diagnosed with HPV treated freely. In 2015, LAPO improved the health status of over 200,000 community members across the country through enlightenment, screening and referral services. Between January and October 2016, LAPO reached a total of 521,570 persons through social, health and legal aid services.

He thereafter called on all well-meaning individuals and organizations to support LAPO in the implementation of the project and thanked everyone for their presence and attention.

Goodwill message by the Minister of Health, Prof Isaac Adewole
The goodwill message by the Hon. Minister of Health, Prof Isaac Adewole was read by his representative, Prof Michel Imade, the CMD of UBTH. The minister could not attend due to flight schedule change and therefore sent his apologies. He began by acknowledging the presence of guests and everyone seated. He talked about cancer becoming a critical health matter that is being addressed by government. Prof Adewole said the country is putting in place structures like the National Cancer Centre which shall be dedicated to the care of persons with cancer, when completed. He stated that government has designated seven centres as centres of excellence to manage cases of cancer with UBTH as one.

The minister said government has also finalized plans to replace four obsolete cancer treatment machines in Benin, Sokoto, Abuja and Lagos. Of the four, only one is functional at the moment. UBTH has a centre for diseases control where screening for cancer is done. The challenges of cancer care are beyond what the government can do alone, that is why on behalf of the Ministry of Health, we are congratulating and applauding LAPO. Cancer is curable if detected early. The machine costs about six hundred million naira; that is why the treatment is expensive but the drugs are cheap, so early detection is the only way forward. He thanked LAPO on behalf of the Federal Ministry of Health for their effort.

Paper presentation on Types of Cancer, Early Detection and Management by Prof. M. Momoh

The guest speaker, Prof. M. Momoh who was ably represented by Dr. Irowa Omorodion stated that cancer is ‘senseless’ in the sense that it kills its host and dies with it. In biological relationship there is nothing to describe such.

Causes of Cancer:

The Guest Speaker stated that cancer is caused by external factors, unhealthy diet, smoking, etc. The internal factors are few in number. When you put all cancer cases together, internal factors are less than 10%. Lastly, environmental factors play important role in cancer.

Various types of cancer:

The focus of the discussion is the various types of cancer, how you can detect them, manage or treat them. First of all, we have breast cancer and its prevention. The statistics of breast cancer as at 2012 indicates that it constitutes 25% of cancer disease in females. About 1.7 million new cases of breast cancer were detected mostly in developing countries. In Nigeria, (Ibadan and Benin) about 77% of breast cancer are in their late stages. Most breast cancers start as lumps, the person needs to go for an examination and investigations. For prevention, we have to know and stop the risk factors. Start the treatment early and complete the treatment regimen. Managing breast cancer is very difficult and challenging. Prevention requires monthly breast examination and adequate diet.

Paper presentation on Policy, Services and Responsibilities related to cancer control in Nigeria by Dr. Omokhoa Adeleye

Dr. Omokhoa Adeleye of the Department of Community Health, UNIBEN/UBTH presented a paper on the Policy, Service and Responsibilities related to cancer control in Nigeria.

Sexual/Reproductive Health and Cancer Policy:

Dr. Omokhoa Adeleye stated that one of the objectives of the National Reproductive Health Policy and Strategy is to achieve quality reproductive and sexual health for all Nigerians. The policy is aimed at reducing the incidence and prevalence of reproductive cancer and other non-communicable diseases (FMOH 2001a). He elucidated on the police issues as it concerns the national family planning and reproductive health policy guidelines and standards of practice (FMOH 2001b). He further explained the policy components of the prevention and management of cancer of the female and male reproductive systems as parts of reproductive health service policy. He advised people to come out for regular screening for early detection and timely treatment.

Policies on Cancer Control:

There is no single policy that addresses cancer control in Nigeria, but cancer control is addressed in some policies on reproductive health. The National Family Planning/Reproductive Health Policy Guidelines and standards of practice (FMOH2001b) address the prevention and management of cancer of the female and male reproductive systems as parts of reproductive health services.

The speaker noted that the national family planning/reproductive health policy guidelines and standards of practice (FMOH2001b) address the responsibilities in reproductive system cancer in terms of services and providers at various levels including Community, health post, Basic Health Centre Level, Comprehensive health Centre, General Hospital, Specialist Tertiary Hospitals. These responsibilities are accompanied by a commitment to provide appropriate logistics at all levels for the management of reproductive system cancers. 

Five major Policy Gaps in Cancer Control:

The speaker, Dr. Omokhoa Adeleye noted the five major limitations in cancer control to include the following:

·       Low level of implementation of existing policies largely due to inadequate resources;
·       Targets outlined for reproductive health cancers in the core policy on reproductive health lack indicators and are not time-bound;
·       Too many overlaps and duplication of policy components and guidelines with different extent of coverage;
·       No attention is given to non-reproductive system cancers
·       No specific policy on cancer management.

Recommendations:

The paper presenter believed that for cancer control efforts to be effective in Nigeria, the following steps must be taken:

·       Develop a concerted policy and guidelines on cancer control at all levels
·       Improve implementation of cancer-related policies
·       Set time-bound targets with indicators
·       Reduce overlaps and duplications in policy statements
·       Address non-reproductive system cancers.

Conclusion:

In conclusion, Dr. Omokhoa Adeleye, who is also the project consultant posited that:

·       Cancer is a major cause of death in Nigeria;
·       Existing policies on cancer control made adequate provision for responsibilities but not for service;
·       There are important resource limitation in the control of cancer at all levels;
·       Existing policies on cancer control only cover reproductive system cancers
·       Finally, Cancer policy integration and improved service delivery is advocated.