Strengthening the Role of Cadres and Village Midwives to Support the Cervical Cancer Awareness Movement in Puhu Payangan Village, Gianyar, Bali, Indonesia

Abstract

Cervical cancer is the most common type of cancer in Balinese women, and most of the cervical cancer patients came in advanced condition. The health survey conducted in the village of Puhu, Payangan, Gianyar, found that the coverage of cervical cancer screening is 12%, which is considered as low. Payangan’s sub-district health centers (Puskesmas) have made an effort to give free PAP smear screenings to the local community, but it still has not received a good response. This is related to the community’s lack of knowledge on cervical cancer, low awareness of cancer screening, and false stigma about PAP smear examination. To overcome this problem, an effort is needed to increase awareness about the need for PAP smear screening by shaping it into a cervix cancer awareness movement "Gardavi", involving village midwives and housewife members of Empowerment and Family Welfare Group (PKK) in Puhu Village as cadres. Methods that are used in this community service include training for midwives, activation of tiered information system involving midwives-cadres and the community, knowledge provision as well as motivating cadres. This event is done to increase the role of village midwives and cadres to actively participate in PAP smear screenings in their region, therefore, it may increase screening outcomes and lower mother morbidity and mortality numbers due to cervical cancer. This event results in increased midwives’ knowledge and skill on the technique of sampling PAP smear independently, increased visits to the Community Health Sub-Center (Pustu) for PAP smear examination, creation of a midwives-cadres-community coordination system, cadres independently playing an active role in motivating the village community to do screening, as well as increased cadres’ optimism.

Impact of Social Distancing on COVID-19 and Other Related Infectious Disease Transmission: A Systematic Review

“…Some countries opted for far stricter almost draconian distancing policy while others are not and depend much on individual or organization or company following administration of infection policy and guideline. Previously, these measure of restricting movement of population proven to be highly effective in preventing spread of contagious disease, for example the transmission of SARS which focused more on isolation and quarantine implementation with other distancing policy applied were far more lenient, less elaborate compared to the current policy for COVID-19 that could be due to the much smaller scale of transmission of SARS [19]. The aim of social or physical distancing during COVID-19 is to reduce transmission rate of COVID-19, hence maintain flatten the curve which allow healthcare system to prepare adequately if needed [20].…”

“…A total of 8 studies were included in this analysis (Appendix A). These studies were conducted globally from United Kingdom [12], Canada [13], America [14], [15], South Korea [16], [17], Australia [18], and Finland [19]. The themes discussed by all studies were the impact of social distancing as a control measure of COVID-19 pandemic toward COVID-19 cases, also on other infectious disease trends.…”

“…5 types of study are looking at COVID-19 patterns, namely, time series analysis, modeling study, cohort, and two cross-sectional studies [12], [13], [14], [15], [16]. While other infectious diseases, such as Human Immunodeficiency Virus (HIV), other sexual transmitted diseases, influenza, respiratory syncytial virus (RSV), and Vaccine-Preventive Disease (VPD) are being observed through cohort and cross-sectional studies [17], [18], [19]. There is one multi-country study and two multicounties study that were conducted to get the overall pattern [12], [14], [15] as compared to the rest of the studies which conducted in only one country or locality [13], [16], [17], [18], [19].…”

“…While other infectious diseases, such as Human Immunodeficiency Virus (HIV), other sexual transmitted diseases, influenza, respiratory syncytial virus (RSV), and Vaccine-Preventive Disease (VPD) are being observed through cohort and cross-sectional studies [17], [18], [19]. There is one multi-country study and two multicounties study that were conducted to get the overall pattern [12], [14], [15] as compared to the rest of the studies which conducted in only one country or locality [13], [16], [17], [18], [19]. The resultant effect of social distancing can be seen on the general population from five studies [12], [13], [14], [15], [17], while three studies were focussing on the sample population among workplace cases (e.g., workers, customers, patients, and students), gay/bisexual and children [16], [18].…”

The Burden of Penile Cancer in Bali Compared to Other Provinces in Indonesia

“…Low incidence of penile cancer in developed countries such as the United States, with an ASR of 0.81 cases/100,000 males, was suspected to be indirectly associated with the success of the HPV vaccination program for women [4]. A different condition is found in Bali, where the incidence of cervical cancer remained the second most frequent malignancy found among Balinese women, and coverage of pap smear screening remained low [20]. Moreover, HPV vaccination coverage which was still low coupled with the sub-optimal implementation of the vaccination program, may have contributed to the high incidence of penile cancer in Bali and other Indonesian provinces.…”