Doctors With Africa (CUAMM-Ethiopia) & Bristol Myers Squibb Foundation

Need

This project responds to the health needs and gaps funded in the District of Hamer and Dasenech, South Omo Zone (SNNPR) in the field of prevention and treatment of cervical and breast cancers, HIV, TB and viral hepatitis. The Zone has a total population of 714,588 in 8 districts; its capital town, Jinka, is located at 750 km from Addis Ababa in the South direction. The two districts have a total population of 74,362 and 64,808, respectively.

In the project area different cultural factors favors the transmission of HPV including polygamy, sub-optimal use of condom and lack of HPV vaccination; some of the known predisposing factors of cervical cancer are also prevailing: the tradition of initiating sexual intercourse at early age and the suboptimal use of family planning and poor health-seeking behavior.

Precancerous screening and treatment services are only at Jinka hospital level, where 45 screening of cervical cancer using Visual Inspection with Ascetic Acid (VIA) for women in age category of women aged between 30-50 were performed with 4 positive cases (9% prevalence) and 2 of them were treated with cryotherapy in the last year. LEEP service is not available in the area for severe lesions treatment and patients are referred to Addis Ababa.

Gender inequality, polygamy and poor economic conditions have resulted in the increase of commercial sex-workers. Booming tourism and low level of community awareness are also high risk factors for the spread of HIV in the area. The number of expected HIV positive cases are about 1,588/year. Only 10% of the sexual active population is screened for HIV, and only 7% of those positive are on ART. The quality of the Voluntary Counseling and Testing services, although performed at all 6 health centers, needs improvement. Only Jinka Hospital and Turmi Health Centre are actually providing ART and the full package for Prevention of Mother to Child Transmission. Not all health centers are actually providing screening for TB, due to basic equipment gaps and to unsafe and unclean facilities. Only 50% of the TB detected positive cases are on treatment. Community follow up for TB treatment as well as for ART compliance is yet unexplored.

The area is also an environment at risk of much Viral Hepatitis: based on Turmi Health Centre data, there is a high prevalence of Hepatitis B, with about 18% of pregnant women tested positive. Hepatitis B early detection and treatment services coverage is limited: only Jinka Hospital, Turmi, Dimeka and Arbore Health Centers are able to detect the virus. No health facility is actually providing screening for at-risk groups namely family members of HBV/HCV positive patients, health workers.