VIA (Visual Inspection With Acetic Acid) Service Goes to Public to Make Jakarta Free From Cervical Cancer

Abstract

Background and context: According to GLOBOCAN data 2012, cervical cancer in Indonesia was in 2nd rank of cancer incidence for women in Indonesia. Aim: To raise public awareness toward cervical cancer and to increase the number of citizens who go through the early detection procedure of cervical cancer in Jakarta. Strategy/Tactics: In January 2017, Department of Health of Special Capital Region of Jakarta issued a new policy to increase the rate of cervical cancer screening in the city. The new policy includes: 1. A new reporting system in which all the patients who are subjected to cervical cancer screening to be recorded in a special form, so it can be well reported and traced. 2. The changes in the conventional way of cervical cancer screening in primary health centers into mobile service to make the medical staffs able to easily reach patients who live in peripheral areas in Jakarta. Program/Policy process: The enhancement of health education on cervical cancer and health promotion regarding the importance of cervical cancer screening using public transportation (Transjakarta bus), Papanicolaou test, and VIA test socialization in primary health centers. The results were obtained and assessed between January 2017-December 2017. Early detection rates were expected to increase by 50% compared with 2016. Outcomes: The results obtained include: 1. The new reporting system works as expected, tracing the patient with a positive VIA value becomes easier to monitor. 2. Medical teams are more active on introducing the early detection cervical cancer screening to society. 3. Various innovations were carried out, among others, by using public transportation, motorcycles to carry the medical tools and devices, a modified car that is equipped with mobile health services, and a house of citizens and the community hall that were turned into a place for examination. The number of people who have started to realize to do early detection after being educated with the knowledge of VIA test and cervical cancer is increased. The number of citizens who joined the cervical cancer early detection in 2016 was 48,960. After the policy and innovation was applied, the number increased into 105,060 citizens (increased by 114% from the previous year). What was learned: The increase of early detection rate of cervical cancer is quite significant from the previous year. For patients with positive result in their VIA test, cryotherapy was included as the part of treatment and follow-up. Costs incurred due to the treatment of cervical cancer can be reduced. With the result of this study, we can learn that there is an improvement in the quality of health services so that the number of deaths and morbidity from cervical cancer in Jakarta can be reduced.