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Track 1: Clinical research priorities and capacity building
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June-September 2015: formation of a cancer research advisory board; formation of a dedicated training working group to set national cancer research and control training priorities and capacity building needs September 2015: first cancer research advisory board meeting December 2015: in-person regroup to define subcommittee working groups: Channels of Communication for Cancer Research; Advisory Committee for Cancer Research; Convening Panels on Priority Cancers; Resource Mobilization for Cancer Research Establishment of NCI-Kenya and board to be the central leading and organization body of cancer research and control activities of the MoH.
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Communication channel among in-and out-of-country researchers Integrate research into the national agenda Convene panels to assess current programs research gaps Identify capacity building needs, centralize training information Conduct grant writing workshops, instruction in research management
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Track 2a: Pathology
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Pathology resident trainings in FNA/BMA: a total of 34 Medical Officers, 2 clinical officers, and 14 technologists have been trained since the inception of the program in Jan 2016. A total of 922 FNAs and 92 BMAs have been performed during the first eight months of the program, an increase of 66% in FNAs and 360% in BMAs from the pre-training baseline numbers (554 FNAs and 20 BMAs), to the pre-training baseline numbers. NCI Administrative Supplement to Promote Cancer Prevention and Control Research in Low and Middle Income Countries (Par 15-155) grant for building capacity in diagnosis of 4 selected cancers; the objective of the program has been to compare the knowledge gained after a lecture-based course and a case-based learning approach for practicing pathologists and senior residents in anatomic pathology based in East Central and Southern Africa.
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Upgrade pathology services to create Centers of Pathology Excellence in select level 5 hospitals Expand pathology training opportunities Standardize pathology reporting through adoption of electronic synoptic reporting (challenging process due to lack of Lab Information Systems and costs) Launch telepathology program (finalize process on both ends and confirm appropriate technology)
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Track 2b: Cancer Registries
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NCI support for 3 population-based cancer registries (PBCRs), matched by the Government of Kenya April 2015: quality and needs assessment of the current PBCRs Four full-time registrars hired, two in Nairobi and two in Eldoret Expanded office space received for the registry program Received a donated vehicle for the Nairobi registry Reached out to earmarked counties for expansion program Trained staff from additional counties on principles and practices of cancer registration Developed Memorandum of Understanding to be signed by KEMRI and the County Executive Committee Health
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Strengthen Kenya’s three PBCRs and establish additional PBCRs in seven counties Develop hospital-based cancer registries in level 5 hospitals Establish a National Population-based Cancer Registry Central Data Center, merging data from regional PBCRs Hiring of 8 additional staff at these three registries Standardize reporting tools to capture all variables required by cancer registries
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Track 3: Cancer awareness and education
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August 2014-present: community education working group initial planning and review of existing studies about and availability of cancer information Regroup meeting held in April 2016 to re-evaluate action plan, establish Cancer Awareness and Education Working Group, and define scope of collaborative work Plans underway to conduct systematic review of existing cancer-related Knowledge, Attitudes, and Practices (KAP) studies in order to inform further research and population-based information needs. May 2015-present: advisors from the American Cancer Society (ACS) and MoH conduct desk review and KAP study to inform adaptation of ACS cancer patient information at the national referral hospital level
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Engage community leaders and members to identify key drivers of stigma through KAP studies Develop culturally appropriate messages to address perceptions and knowledge gaps Raise public awareness about cancer prevention and early detection; reach 60% of the population by 2018
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Track 4: Health System Strengthening and National Policy Development
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Development of oncology fellowship curriculum for physicians at Moi Teaching and Referral Hospital Expansion of radiotherapy services: additional linear accelerator at KNH, public-private agreement to use availability of machines at private facilities for backlog of public hospital patients Drafting of Cancer Center Guidelines Development of treatment protocol Establishment of a bi-lateral MOU with NCI Kenya to strengthen cancer research and control. April 2015-present: developing cancer management protocols: priority cancer selection and committee membership May 2015-present: developing Guidelines for Establishing a Comprehensive Cancer Center June 2015-present: coordinating dialogue: patient financing, childhood cancer consortium February 2016: Government announces the National Hospital Insurance Fund will cover cancer related activities.
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Leverage HIV/AIDS infrastructure (referral, transportation networks) established through PEPFAR Develop curricula for referral systems and training Include essential cancer drugs in the KEMSA drug list Support MoH to establish radiotherapy units, cancer treatment and palliative centers
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