Nu 1.109-billion to implement health flagship for three years

Nu 1.109-billion to implement health flagship for three years

Lhakpa Tshering

The health flagship project to prevent cancers – gastric, cervical, and breast – launched recently by Health Minister in Mongar Eastern Regional Hospital has placed Nu 1.109-billion that ends in 2023.

The key priority for early screening and detection for gastric cancers would require Nu 616-million, while Nu 310-million is estimated for cervical cancer and Nu 144-million for breast cancer. It has also set aside Nu 34.572-million for project management including monitoring and evaluation and Nu 5-million for the training of health workers.

Of the total, Nu 100-million will be executed for 2020-21 and Nu 689-million for 2021-22 while Nu 320.572-million will be executed in 2022-23.

With the rollout of the health flagship program, it will contribute to reducing the incidence and mortality of gastric, cervical, and breast cancer through early screening programs and improving the existing cervical cancer screening program.

The strategies involve the introduction of new screening tests to reach all the target populations and provide treatment, sustained health advocacy, and having adequate human resources in place.

By the end of 2023, the gastric cancer program will screen all populations aged between 18 to 75 years for H. pylori where the positive cases will receive triple therapy treatment, and all high-risk target populations aged between 40 to 75 years for screen and treatment.

Similarly, all women aged between 40 to 65 years will be screened for breast cancer while the cervical cancer project will screen all eligible women aged between 30 to 65 years where the positive women will receive treatment and management.

However, unlike cervical cancer, there is no national screening program for gastric cancer and breast cancer.

The rapid socio-economic development, the national goal of universal health coverage, and the epidemiologic transition of diseases to more non-communicable diseases and cancers have resulted in more demand for tertiary healthcare services, expansion of health facilities, and increasing patient referrals, leading to escalating costs for healthcare providers.

About 62 percent of cancer cases were referred out of the country for treatment and confirmation of diagnosis.

The highest number of stomach cancer cases was from Paro, followed by Wangdi Phodrang, Punakha, Tashigang, and Haa, and while the highest number of cervical cancer cases was from Tashigang, followed by Mongar, Wangdi Phodrang, Chuhkha, and Samtse.

According to the health flagship blueprint 2020-2023, the top five cancers in males are stomach, esophagus, liver, and lung and rectum cancer, whereas cervix uteri, stomach, breast, thyroid, and ovary cancers are the five leading cancers in females.

The leading cancer deaths in male is due to stomach cancer, followed by esophagus, liver, lung and gallbladder cancer and in the female is because of cervix uteri, followed by stomach, lung, ovary and liver cancer.

However, it was found there is not much effort being put into preventing these cancers, both in terms of programmatic interventions or financial resources.

According to the ministry, more sensitive screening tests and comprehensive patient-centered or population-friendly screening programs are found to be necessary to achieve the desired outcome of the program. 

The health flagship project, therefore, aims to speed up health gains by targeting areas with significant health outcomes but not adequately covered by the 12th Five-Year-Plan. 

For the successful implementation of the flagship project, the Project Management Unit (PMU) will be established in the Ministry of Health with a project manager, three project coordinators, one monitoring and evaluation officer, an administrative assistant, and an accountant identified from within the ministry.

The project Steering Committee (PSC) will be formed to give the strategic guidance for implementing the project and a technical working group comprising the experts will be formed to give technical guidance for the smooth implementation of the project.

The PMU will work closely with the districts, relevant departments, and programs within the ministry and report to the Prime Minister’s Office on the progress of the program monthly, quarterly, and annually.