Setting up an information system to prevent cervical cancer: the SUCCESS project

expertise france workshop

This case study was part of our 2022 Impact Report.

The most common of them is the human papillomavirus (HPV) which causes more than 70% of cervical cancers and precancerous cervical lesions. Furthermore, women living with HIV are more vulnerable to infectious diseases and 6 times more likely to develop cancer. Cervical cancer has become a major cause of death for the 16 million women living with HIV worldwide.

The SUCCESS project (Scale Up Cervical Cancer Elimination with Secondary Prevention Strategy) aims at reducing morbidity and mortality from cervical cancer in four countries: Côte d’Ivoire, Burkina Faso, Guatemala and Philippines. The focus is set on improving access to optimal products to diagnose and treat cervical cancer.

By reducing barriers to accessing efficient new technologies, this project should allow the screening of 185,000 women, 40% of whom are living with HIV. 

The SUCCESS project  is funded by Unitaid and implemented by Expertise France, in collaboration with a consortium that holds experience and expertise in cervical cancer prevention and control: Jhpiego and UICC. The project also relies on the technical support of national cancer institutes: the French National Cancer Institute, the National Cancer Institute (USA), the National Cancer Center (Japan) and the National Cancer Institute (Brazil). Bluesquare works with the consortium to pilot an m-health platform that aims to improve patient follow-up.

 Strengthening the following-up of women over time

Bluesquare joined the project in Côte d’Ivoire and Burkina Faso to strengthen the following-up of women over time, from routine HPV testing to clinical treatment in case of complications. Patients were initially monitored with paper-based forms but the SUCCESS project rapidly faced the need for a consolidated patient record and structured data collection for both operational and monitoring reasons. 

In close relationship with IT departments and Cancer programs in countries ministers of health, Bluesquare is in charge of:

  • Digitizing the patient pathway in a single patient record platform
  • Setting up a SMS reminder system plugged to the patient record platform
  • Integrating these new tools in the MOH data environment and build local capacity to manage these tools autonomously

In order to move forward, we had to process an analysis of the existing technical architecture and data environment in both countries. This allowed us to assess the needs for data analysis and visualization. We also reviewed clinical procedures to formalize the care pathway and the data collection forms.

During the initial analysis, Bluesquare provided technical assistance for digitizing the paper-based data collection tools while using the existing patients’ clinical pathways. Our team finalized the necessary tools, in a collaborative approach engaging national stakeholders and end-users.

Dr. Amadou Sagnon (MOH), Marie-Ange Zannou (JHPIEGO), Armand Ouedraogo and Apollinaire Nombré at meeting in Burkina Faso.

Integrating digital tools in the countries’ data environments

Our technical team proposed a solution based on DHIS2 Tracker, a feature of the DHIS2 open source platform that allows to collect and track individual-level data of numerous patients over time. We combined this with the DHIS2 Capture mobile application thanks to which health workers can collect data directly from their mobile phone or tablet.

On top of that, we have set up an SMS server plugged on this platform to remind patients when they have to get tested. This architecture based on the open source DHIS2 technology is quite standard but requires a particular attention to details in terms of DHIS2 Tracker configuration, tablets memory management and SMS server setup.

Finally, the data platform will host personal and sensitive data. The project has thus implemented a clear data sharing policy security procedures to regulate access to data.

Bluesquare has worked in close collaboration with the ministries of health’s IT departments in Burkina and Cote d’Ivoire to develop our solution. With this approach, we ensure the sustainability of our solution even after our technical support.

100,000 women affected by this program

This data platform will have great impact for both the women that this program follows over time and for the medical staff. It is estimated that more than 100,000 women in Côte d’Ivoire and Burkina Faso will directly benefit from the solution set up by Bluesquare.

Clinical operations will also greatly benefit from it. The medical staff will indeed have access to all patients’ information in one place. It will also improve the communication between laboratories and health centers that can now discuss test results through the platform. And as mentioned earlier, thanks to this solution, patients will get reminders for their routine HPV testing.However, patients and medical staff are not the only ones that will benefit from this platform. The database created will constitute a unique data source for research on cervical cancer in West Africa. The outcomes for this project, and other of his kind, go much beyond the immediate results.