Social & Cultural Basis For Community And Primary Health Programs

Please use this proposal form only; submissions not using this format will not be accepted.

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Blog Proposal Form

Lab 5: Stakeholder Advocacy for a Current Health Policy Issue NAME/S OF BLOGGER/S:

ABC DEF

Identify no more than 6 major stakeholders. Write the name specific organizations, agencies, associations as stakeholders, not vague or general human groupings (e.g. not “malaria patients” but an actual Association that promoted child health). Remember that legislators, council members and such are the actual policy makers, not the stakeholders per se. Stakeholders must have an actual or potential interest in the policy/issue and an identifiable position on the issue. This can often be discerned from their websites and from news articles. The actual position may currently be in favor, against or even uncommitted.

Fill out the three charts below to complete your blog proposal. Note that your topic may focus on adopting a new policy, repealing an existing policy or pressing for adequate funding and/or implementation of an existing policy.

1. BRIEF DESCRIPTION

Topic: A public health professional’s viewpoint: Creating a national breast cancer screening policy in Jamaica a. Specific Country, State, Local Government concerned: Jamaica b. Nature of the policy issue Breast cancer is the leading cause of cancer death among Jamaican women. Although Jamaica’s age­standardized incidence rate of breast cancer was expected to rise with the introduction of mammography, as it did in other countries, it has remained relatively stable. This discordance may be explained by Jamaica’s under­utilization of mammography services and the lack of a national breast cancer screening policy. In the absence of a national breast cancer screening policy, many cancers will go undetected at early stages when cancer is most treatable. Currently, mammography services are not freely available in the public sector, effectively excluding those who cannot afford mammogram services at a private clinic or pay for the lower cost mammography through the Jamaican Cancer Society (JCS). Furthermore, those women who can afford mammography are less likely to seek screening services without the referral of a physician. In the absence of screening policy, physicians may not provide mammography referrals at screening appropriate ages or when clinically indicated. A national breast cancer policy would standardize age at screening and allocate funding for public sector mammography services. Though many stakeholders support the development of a national breast cancer screening policy, governmental action has been stagnant due to funding limitations.

Please use this proposal form only; submissions not using this format will not be accepted.

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c. Your/your group’s position on the issue As future public health practitioners, we firmly support the development of a national cancer screening program in Jamaica. We believe that a national screening policy would improve access to mammography services, provide physicians with screening guidelines, and increase awareness of breast cancer among patients. The cost of implementing such a policy should be viewed in the broader context of cost savings from the early detection of breast cancer and thus decreased utilization of expensive late stage cancer care.

2. STAKEHOLDER ANALYSIS Stakeholders Characteristics

Involvement, interest and importance of group concerning the policy issue

Position on Issue: for, against, uncommitted)

1. Jamaica Cancer Society (JCS)

High interest­­Firmly supports early detection of all cancers. High involvement­­Firmly advocates for a national screening policy. JCS provides low­cost mobile mammography services and is seeking to expand mammography accessibility in 2015. High importance­­ Nationally recognized non­profit, non­governmental organization with very high visibility

For the policy

2. Ministry of Health (MoH)

Moderate interest­­Allocates funding to the Regional Health Authorities so they can deliver care according to its National Health Policy and Strategic plan. Low to moderate involvement­­ Though there is a brief mention of cancer control in its National Health Policy, there are no breast cancer specific guidelines. MoH is largely focused constructing policy in accordance with the Millennium Development Goals with an emphasis on decreasing communicable diseases rather than non­communicable diseases. High importance­­the preeminent government organization that is responsible for setting health care priorities, health care delivery and public health.

Uncommitted to the policy

3. Ministry of Finance and Planning (MoFP)

Low/Moderate interest­­Provides funding for training oncology nurses via funds provided to the Culture, Health, Arts, Sports, and Education Fund (CHASE). Low to moderate involvement­­MoFP provides funding to MoH, JCS, and CHASE whom all support breast cancer programs and policies. A grant is also provided to the St. Joseph Hospital which houses the Consie Walters Cancer Hospice. MoFP does not provide funding for direct breast cancer initiatives, but merely supports the health systems and programs for Jamaica. High importance­­MoF has an overall responsibility for developing the Government’s

Uncommitted to the policy

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Stakeholders Characteristics Involvement, interest and importance of group

concerning the policy issue Position on Issue: for, against, uncommitted)

fiscal and economic policy framework. 4. Pan American Health Organization (PAHO)

High interest­­Coordinates collaborative efforts with partner organizations to develop and sustain comprehensive cancer control programs (which include breast cancer). High involvement­­Advocates and communicates to raise the priority of breast cancer on the public health agenda. High importance­­World’s oldest international public health agency.

For the policy

5. World Health Organization (WHO)

High interest­­Supports notion that early detection is the foundation for breast cancer control. High involvement­­WHO promotes general public awareness to the issue of breast cancer and the mechanisms to control. WHO also strongly advocates for policies and programs for population­based breast cancer control. High importance­­WHO is the directing and coordinating authority on international health with the UN systems.

For the policy

6.The Breast Health Global Initiative (BHGI)

High interest­­Strives to improve breast health outcomes and access to breast cancer screening, detection and treatment for women in Low and Middle­income Countries (LMCs). High involvement­­BHGI creates guidelines to define best practices with limited resources for early detection, diagnosis and treatment, and health care systems and public policy. High importance­­International alliance of the world’s leading health organizations, agencies, associations, and experts

For the policy

3. WEB LINKS AND RESOURCES Name URL Brief Description ‘Jamaica lacks breast­cancer screening policy’

http://jamaica­gleaner.com/gleaner/2 010 1025/lead/lead6.html

The JCS reports that Jamaica’s absence of a national policy on breast­cancer screening is hampering the island’s fight against the disease.

PAHO Cancer Program

http://www.paho.org/hq/index.php?o ptio n=com_content&view=category&layo ut= blog&id=1866&Itemid=3904

The Cancer Program managed by PAHO advocates for the cancer prevention, screening and early detection, diagnosis and treatment, and palliative care.

The Breast Health Global Initiative (BHGI)

http://portal.bhgi.org/Pages/AboutBH GI. aspx

BHGI is a global initiative that provides guidelines for economically feasible development of breast

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Name URL Brief Description cancer control and preventive programs.

WHO http://www.who.int/cancer/detection /brea stcancer/en/

WHO promotes breast cancer control within the context of national cancer control programs and integrated to noncommunicable disease prevention and control through implementation of combined cost­effective and affordable interventions to tackle this highly preventable disease.

Jamaica’s National Health Policy 2006­2015 and Strategic Plan for 2006­2010

http://www.caribbeanelections.com/e Doc s/strategy/jm_strategy/jm_National_H eal th_Policies_2006_2015.pdf

The MoH has a five year strategic planning cycle. The most recent plan too effect in April 2006. Its priorities were set in accordance to the Millennium Development Goals which emphasizes control of communicable diseases with minimal mention of control of noncommunicable diseases like cancer.

Ministry of Finance and Planning Estimated Expenditure report for 2015­2016

http://www.mof.gov.jm/documents/d ocu ments­publications/document­centre/ file/ 928­estimates­of­expenditure­2015­20 1 6.html

MoFP has the primary responsibility of developing and managing the governments fiscal and economical policy framework, but also plays a role in socio­economic development of the country and cost­effective delivery of public services.