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EP378/#519  Cervical cancer prevention program in Nepal: a comprehensive ‘train the trainer’ approach
  1. Jitendra Pariyar1,
  2. Samantha Batman2,
  3. Madan Piya3,
  4. Sandhya Chapagain4,
  5. Poonam Lama1,
  6. Pabitra Maharjan1,
  7. Maya Neupane3,
  8. Natacha Phoolcharoen5,
  9. Ellen Baker2,
  10. Melissa Varon2,
  11. Mila P Salcedo2,
  12. Jessica Milan2,
  13. Shashwat Pariyar3 and
  14. Kathleen M Schmeler2
  1. 1Civil Service Hospital of Nepal, Gynecologic Oncology, kathmandu, Nepal
  2. 2The University of Texas MD Anderson Cancer Center, Gynecologic Oncology, Houston, USA
  3. 3Cancer Care Nepal, Medical Oncology, Lalitpur, Nepal
  4. 4National Academy of Medical Sciences, Bir Hospital,, Radiation Oncology, Kathmandu, Nepal
  5. 5King Chulalongkorn Memorial Hospital, Gynecologic Oncology, Bangkok, Thailand


Introduction Cervical cancer is a leading cancer in Nepal. Lack of access to screening and trained health professionals to manage preinvasive and invasive cervical disease contributes to high cancer incidence and mortality.

Methods Cancer Care Nepal (CCN) and MD Anderson Cancer Center (MD Anderson) partnered to implement a ‘train the trainer’ (TOT) program to teach cervical cancer screening and management. TOT courses were held for specialists from five institutions throughout Nepal to learn how to deliver these trainings. Each participating institution then held local courses for nurses and doctors. The training was complemented with monthly Project ECHO® (Extension for Community Healthcare Outcomes) telementoring videoconferences.

Results Two TOT and five local training courses were held for providers from 20 centers from November 2021 to October 2022. During COVID-19 pandemic travel restrictions, the MD Anderson faculty joined the courses and provided didactics virtually. In-person, hands-on training using simulation models to teach VIA, colposcopy, ablation and LEEP were led by the Nepalese faculty. The 173 participants included 28 gynecologists, 4 gynecologic oncologists, 1 medical oncologist, 22 general practitioners, and 118 nurses. 126 (73%) completed the pre- and post-course surveys with 86% of respondents expressing their desire to make changes in their practice as a result of the courses. In 2022, CCN became a Project ECHO hub and has held 12 sessions with approximately 20 participants from 11 centers per session.

Conclusion/Implications Our TOT and local training courses have increased the reach of training, with the goal of decreasing the burden of cervical cancer in Nepal.

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