LAPO C4 Project
Project Duration: 2017 – 2018
Lift Above Poverty Organisation (LAPO) is a not-for-profit, non-governmental organisation committed to the social, health and economic empowerment of the poor and vulnerable in Nigeria. LAPO was established by Godwin Ehigiamusoe Ph.D, in 1987 while working as a Rural Cooperative Officer in Ogwashi-Uku, Delta state. Over the years, the organisation has demonstrated uncommon commitment to poverty alleviation through the implementation of social, health and economic empowerment programmes targeting disadvantaged groups. The vision of LAPO is a healthy and informed society characterized by prosperity, justice and equity.
A lot of lessons have been learnt through these past efforts within Nigeria and beyond. One major outcome is the realization of the fact that microfinance alone offers limited relief to the poor and the underprivileged in the society.
The LAPOC4 Project
One of LAPO’s key operating assumptions is that poverty is further reinforced by diseases and ignorance. The LAPO Community Campaign for Cancer Control (LAPOC4 Project) is therefore an intervention aimed at supporting efforts by the Government of Nigeria (GoN) to control cancer amongst the general population through policy and media advocacy, social mobilisation for uptake of screening services and strengthening referral linkages from community, primary healthcare to secondary or tertiary centres for cancer prevention, care and palliation.
The LAPO C4 Project is being implemented in FCT (Abuja), Lagos, Edo, Rivers and Imo State. Nigeria, with a population of 170,123,740 is the most populous country in Africa and the seventh most populous in the world. Its gross national income per head in 2012 was US$2700 (at purchasing power parity). According to GLOBOCAN data, almost 102,000 new cases of cancer occur annually in the country, and 75,000 deaths per year are caused by malignant diseases. 5-year prevalence in the adult population is roughly 223,000. Recent data provided by smaller population-based and hospital-based registries suggests that cancer incidence is increasing in the country. The global burden of cancer, one of the major causes of mortality worldwide is high. WHO estimates that there are 14.1 million new cases of cancer and 8.2 million deaths yearly. There are 32.6 million people living with cancer worldwide. 60 per cent of cancer cases occur in women due to breast and cervical cancer while liver and prostate cancers are common among men. However, with early detection, over 80 per cent of cancer cases are preventable while 40 per cent of the disease can be prevented by changes in life style. The main barriers to cancer control in Nigeria include non-efficient policy, insufficient public funding, poor access to screening services for early detection, poor referral linkages between community and health centres, insufficient cancer treatment centres and inadequate awareness.
Cancer is a malignant disease that occurs as a result of abnormal cell division. It is a leading cause of death worldwide, accounting for 7.6 million deaths (about 13% off all deaths). Available data shows that liver cancer is commonest among males while cervical and breast cancer is commonest among females.
Cancer is the number one killer disease of mankind. Cancer kills more people than HIV/AIDS, malaria and tuberculosis combined. The worldwide burden of cancer doubled between 1975 and 2000 and is set to double again by 2020. Furthermore, the International Agency for Research on Cancer (IARC) forecast that by 2030, there will be more than 21 million new cases of cancer, and 13 million cancer deaths every year. In contrast, death from infectious diseases will fall by about 7 million per year.
In Nigeria, over 100,000 Nigerians are diagnosed with cancer every year, out of which about 80,000 die due to late detection. The Nigerian cancer death ratio of 4 in 5 is one of the worst in the world. Cancer and related diseases kill more people than all other causes of death in Nigeria.
Cervical cancer, which is virtually 100 per cent preventable, kills one woman every hour in Nigeria and breast cancer now kills 40 Nigerians every day (compared to 30 daily in 2008). According to a 2013 report by WHO, prostate cancer kills 26 Nigerian men every day (up from 14 daily in 2008).
Cancer — The three Common Cancer ailment that kill 90 Nigerians Daily are:
- Cervical cancer, which is virtually 100 per cent preventable, kills one woman every hour in Nigeria.
- Breast cancer now kills 40 Nigerians every day (up from 30 daily in 2008)
- Prostate cancer kills 26 Nigerian men every day (up from 14 daily in 2008) (W.H.O. Report, 2013).
Economic Burden of Cancer
Economic burden of cancer was $1.16 trillion in 2010 (up from $895 billion in 2008 — equivalent to 1.5 percent of the world’s GDP) and Nigerians spend $200 million annually to seek cancer treatment abroad. Most Nigerians have no access to quality cancer treatment due to the high cost.
Indeed, cancer is the most expensive disease to treat. It takes away more than 30% of the income of the affected household. Therefore tackling the problem indirectly solves other related problems like children dropping out of school and poverty.
The good news is that most cancer ailments are preventable through massive awareness creation, lifestyle changes, early detection and timely uptake of quality treatment (World Health Organisation, WHO 2002).
LAPOC4 - A Community-Based Project
The project services will be delivered by local organisations (CBOs) at the population level. These include targeting community groups- schools, market, religious gatherings, etc. for social mobilisation through interpersonal communication (IPC), IEC materials, referrals and screening services.
The LAPOC4 Project will be implemented in the following States:
- Rivers and
Reduced rate of cancer related deaths among target population in Nigeria by 50% by year 2018
- Increase awareness of cancer among rural men and women in target states by 25% by year 2017
- Promote culture of early detection among target population
- Advocate for policy and practice change to enhance awareness, screening, and care for cancer patients in Nigeria
- Advocate for establishment of screening centres at PHC level
- Advocate for subsidized screening at PHC level
- Advocate for subsidized screening and treatment for less privileged women with cancer in Nigeria
The target population for the project is the general public with focus on:
- Women for breast and cervical
- Men for prostate cancer (men)
- Men and women for childhood cancer
The LAPO Community Campaign for the Control (LAPO C4) project is aimed at reducing cancer-related deaths in Nigeria by focusing attention on activities that promote prevention and early detection. Cancer prevention will be achieved through education of the populace on the pre-disposing factors, signs and symptoms while early detection will be achieved through massive drive for the provision of screening services.
Theme: “War Against Cancer: All hands on deck”
Slogan: Join the LAPO C4 train… Go get checked
The Project Strategic Interventions
- Capacity Building
- Advocacy – For policy and practice change
- Inclusion of screening services at PHC level in Nigeria
- Provision of subsidized Screening at PHC level
- Provision of subsidized treatment for less privileged women with cancer in Nigeria
The capacity of key project staff (project manager, project officer, M&E officer and account officer) of the CBOs that have been engaged for community interventions was be developed for quality delivery of the LAPOC4 services. CBO personnel were trained on cancer prevention through early detection and project management starting with a project inception workshop. They will continue to receive mentorship throughout the duration of project.
Project advocacy will engage stakeholders at local, state and national levels to ensure their commitment to project service delivery and success. The LAPOC4 advocacy will ensure:
- Building linkages with local or community-based organization.
- Building effective synergy with critical groups such as religious organization
- Partnership with Primary Health Care centres
Social Mobilisation and Behaviour Change Communication (Awareness Creation)
The major risk factors to cancer diseases are unhealthy diet, physical inactivity and consumption of alcohol and tobacco including smoking. LAPOC4 activities will address these risk factors by creating general awareness about cancer and promotion of a healthy life style habits among the most-at-risk population in target communities.
The project’s healthy diet and lifestyles prevention messages include:
- Avoidance of alcohol and tobacco including cigarette smoking;
- Regular uptake of cancer screening services by the population that is most at risk
- Increased intake of natural food and adequate diet rich in fruits and vegetables; and
- Recognising warning signs and timely uptake of treatment services for early cancers
Interpersonal communication will be carried out through community meetings, religious centres and market places during which education materials will be distributed. These target groups will carry out social mobilization of their members for free cancer screening services.
Appointment of five campaign ambassadors who are known personalities and influencers within each target state/community.
Sensitize 2,150,000 persons (men/women) on breast, cervical, prostate and childhood cancer within target communities.
Massive deployment of IEC materials, print and electronic media: Posters, handbills, jingles, stickers, road shows, social media, radio jingles in English and selected local languages.
Screening, Referrals and Follow-Up Services
The LAPOC4 screening services for early detection of cancer cases in target communities consist of awareness creation, referrals to screening centres, advocating for the upgrading of target community health facilities for free cancer screening (where not available) and provision of mobile screening services especially during outreaches. The project will develop or update the national directory of facilities providing cancer services for the strengthening of community-facility referral linkages. The implementing CBOs will follow up on referrals to ensure uptake of services by beneficiaries.
- Referral to identified screening centres - 15,000 persons (5,000 women for breast cancer, 4,500 men for prostate cancer and 5,000 women for cervical cancer and 500 children for childhood cancer) for screening within target communities/states.
- Upgrade five partner health facilities to provide screening services in target states.
- Provide screening to 5,000 persons (2,000 women for breast cancer, 1500 women for cervical, 1,000 men for prostate cancer and 500 children for childhood cancer) within the target states.
Maintenance of Database
- Database of cancer service centers (screening, treatment, registries)
- Database of cancer support groups and survivors
- Database of cancer-focused non-governmental organisations/civil society
Formation of Community Cancer Control Committee
- Identification of members of target stakeholders – religion, community leaders and groups, LGA, health providers, survivors, etc.
- Monthly meetings of the committee to review project.
The Project M&E Strategy
Monitoring involves the collection and analysis of data about project activities to determine whether project objectives are being achieved and to make necessary changes for project improvement. The M&E strategies include:
- Monthly desk review to aggregate data into the central Project Management Information Services (PMIS).
- Quarterly Site visits for supervision and monitoring.
LAPOC4 ADVOCACY REQUESTS
Government at all levels (Local, State and Federal)
In recognition of the fact that health ministries and related agencies are responsible for health care planning, health policy formulation, infrastructural upgrade across the three levels of the system (primary, secondary and tertiary), implementation as well as supervising health service delivery in the State/the Federal Capital Territory, (FCT) Abuja and at different levels of government (local, state and federal as applicable), LAPO and other partners in the project are advocating, among others, for the following:
- Capacity building opportunities for CBO partners implementing the LAPOC4 programme in the State.
- Provision of published materials such as enlightenment flyers, training manuals and relevant policy documents.
- Regular update of LAPO with Directories of Cancer Registries and Cancer Treatment Facilities across the State/Country.
- Regular update of LAPOC4 partners on current guidelines and protocols for cancer control.
- Approve the partnership with public-owned health facilities for training and screening support services.
- Facilitate active participation of public health facilities and personnel for project service delivery.
- Support or recommend LAPO to relevant national and international development organisations and partners interested in community cancer prevention and control funding.
- Facilitate the implementation of policies with budgetary support, and facilitate government funding of local cancer control interventions.
- Establish Mobile Cancer Centres (MCC) and ensure collaboration of the MCC with LAPOC4 to boost efforts to access screening services by target beneficiaries.
- Expedite action on the processes that will accelerate the passage of the Bill for an Act to Establish the National Centre for Cancer Research and Treatment in Nigeria currently before the Senate of Nigeria. The bill should be domesticated by all States in Nigeria and embrace a holistic approach to the disease by establishing the National/State Agency for the Control of Cancer in the country.
Lift Above Poverty Organisation (LAPO)
4th Floor, LAPO Place
18, Dawson Road, P.M.B 1729, Benin City,
Edo State, Nigeria.
Email: [email protected], [email protected].