Empowering Women to Live Cancer Free

Summary

In 2024, Movement Health Foundation committed to advance gender equality for women and girls in South Africa and Peru through better health care. Movement Health aims to bridge the gap in access to health care and improve health outcomes by leveraging technology and digital solutions and local resources to improve access to early screening and diagnosis of cervical and breast cancers. In South Africa, Movement Health will develop a user-friendly web app to guide users through the cervical cancer screening process and provide navigation, information, and education support. In Peru, Movement Health will apply a proven digital application for increasing access to maternal and newborn health care to the area of women’s cancer care, facilitating referrals and allocation of prevention services. Through tailored interventions, this commitment will serve as a building block for national programs that dismantle barriers to care and promote gender equality in health care. Movement Health aims to impact 50,000 people directly or indirectly in the first stage of scaling.

Approach

Movement Health and local partners commit to combatting cervical and breast cancer in South Africa and Peru by leveraging local resources and technologies to improve patient experiences with sustainable and scalable solutions, expecting to impact 50,000 lives in the initial phase.

This new commitment builds on a successful facility-based, workflow improvement model implemented in Cusco, Peru in 2021, which digitized health worker shift scheduling, improving visibility into provider supply and patient demand. By applying this successful methodology, a solution will be co-created by mapping existing screening capacities, and then building a digital tool for local clinical managers to facilitate referrals and efficiently allocate preventive services for women at risk of cancer.

In South Africa, efforts will focus on awareness-raising, screening facilitation, early referral and adherence to recommendations. An experienced service provider, in collaboration with the Nelson Mandela University Centre for Community Technologies, will develop a user-friendly progressive web app (PWA) to provide the most up-to-date, evidence based health information on cervical and breast cancer to South African women and men. The app will be open to the public and guide users through the cervical cancer screening process, featuring app onboarding, navigation, campaign information, and education. The PWA will offer initial screening information through an interactive questionnaire for personalized risk assessment. It will display nearby providers of cervical cancer screening, pre-appointment preparation and follow-up advice. A communication plan to raise awareness of the app is also being designed as part of the roll out effort.

Movement Health Foundation is providing the expertise of its member institutions in technological solutions, the local existing partnerships, as well as project coordination and financial support to develop and implement scalable, evidence-based interventions. By leveraging available technology and local resources, Movement Health Foundation and partners aim to increase access to life-saving screening services and early cancer diagnosis. Further work in these communities will also elucidate specific gaps in treatment that can be addressed through additional partnership engagement in the future.

Action Plan

Q3-Q4 2024: The intervention design phase in South Africa will take place from August to December 2024, working with a tech developer partner to adapt successful existing interventions. In Peru, a capacity review diagnosis will be conducted over four weeks with expert consultants.
Q1 2025: January to March 2025, the intervention in South Africa will be validated in one district to assess its accessibility and gather user feedback, accompanied by a robust marketing campaign targeting the population. Meanwhile, in Peru, support and technical assistance will include validating performance indicators, defining action plans, agreeing on goals and outputs, and establishing implementation routines.
Q2 2025: Starting in April 2025, South Africa will disseminate the intervention to all nine provinces, targeting three provinces per quarter, and will commence continuous monitoring to measure the uptake of services and linkages to care. Peru will begin disseminating the intervention to 5-6 more regions, phased by two per quarter. The dissemination phase aligns with the financial year for the Department of Health, coinciding with the new budget.
Q3 2025: During July to September 2025, South Africa will continue robust marketing across platforms and further dissemination to additional provinces, along with ongoing monitoring of service uptake and linkages to care. Peru will maintain support and technical assistance while continuing dissemination to additional regions.
Q4 2025: From October to December 2025, South Africa will persist with robust marketing and dissemination efforts, alongside ongoing monitoring. Peru will complete support and technical assistance, submit a scalability proposal, and continue monitoring.
Q1 2026: In early 2026, both countries will maintain their dissemination and monitoring activities.
Q2 2026: From April to June 2026, South Africa will evaluate screening uptake and cervical cancer incidence using provincial data and DHIS, and Peru will conduct an evaluation of the intervention. This timeline provides a clear roadmap for implementation and monitoring in both South Africa and Peru.

Background

Cervical and breast cancer are formidable challenges to women’s health globally, with prominent impact in emerging countries. In South Africa, cervical cancer is the second most common cancer among women, trailing only breast cancer, yet it claims the highest toll of cancer-related deaths. The burden is particularly pronounced among women living with HIV.

Late-stage diagnosis compounds the morbidity and mortality rates, emphasizing the critical importance of early detection. While primary prevention through HPV vaccination is pivotal, secondary prevention strategies, like structured screening programs, are equally essential. However, over 75% of cases in South Africa are diagnosed at advanced stages, underscoring significant gaps in screening coverage, especially in rural and peri-urban areas (STATSSA, 2023; Denny, 2022; NDOH, 2017) .

In Peru there were over 4,000 new cervical cancer cases in 2023, ranking as the second most frequent cancer among women aged 15 to 44, with mortality exceeding 2,000 cases annually (ICO/IARC, 2023) . The COVID-19 pandemic disrupted surveillance efforts, resulting in a decrease of up to 76% of cervical cancer screening tests (Rojas-Zumaran, 2022) .

Progress Update

Partnership Opportunities

Movement Health is looking for partners with proven expertise on health system integration of interventions on user adherence that may provide earlier diagnosis and referral and higher care continuity rates. Movement Health also seeks funding and visibility to support the scaling-up of the intervention in both countries, as well as cross-country collaboration and transferring of capacities to other geographies or adjacent health conditions., Movement Health offers its partners project management, expertise and financial resources for the rollout of this Commitment. The Foundation will work closely with the local public health governing bodies and other implementing partners to firmly embed the projects in the local context to ensure sustainability beyond the funding period. The project will also capture best practices to replicate this initiative in other settings.