Health Flagship Program

The Health Flagship Program aims to lower incidences of gastric, cervical and breast cancers and enable detection of early-stage cancers for timely treatment.

 

Gastric Cancer is one of the common malignancies worldwide and it is still the 3rd leading cause of cancer-related deaths globally. In Bhutan gastric cancer is the commonest malignancy in male with an incidence rate of 8.3 per 100000 population and second commonest malignancy in females after cervical cancer with an incidence rate of 5.2 per 100000 population. The Flagship program aims at Reducing Gastric Cancer incidence & mortality through early screening & prevention.

Currently, all high-risk population within the age group of (40-75 years) are provided endoscopy services and simultaneously all the H. Pylori positive cases are treated with triple therapy treatment. The gastric cancer screening is currently ongoing in Bumthang, Monggar and Wangdiphodrang Dzongkhags. However, from June 2021 population age group (18-75 years) will be screened for H. Pylori using the H.pylori test kits. The details are reflected as follows:

Individuals underwent an Endoscopy

Individuals underwent the H.pylori test

Detected case & action being taken

Worldwide, Cervical cancer ranks as the fourth most frequently diagnosed cancer and also the fourth leading cause of cancer deaths in women. It is the most frequent cancer diagnosed among Bhutanese women with peak incidence in women at 40-49 years of age. The project aims to reduce cervical cancer incidence and mortality through early screening & prevention. The projects will screen all the women within the age group of (30-65 years) for Human Papillomavirus (HPV) and the treatment for abnormality will be carried out as per the guidelines and standards

Pap smear method is used to screen women within the age group of (25-65 years). In addition, pre-cancer lesions are treated with LEEP, cryotherapy and cold coagulation procedures. Currently, cervical cancer screening in Bumthang, Mongar, Punakha and Paro Dzongkhag has been completed with a coverage of more than 99 percent. The details are reflected as follows:

Women screened for cervical cancer (Pap smear test)

Women treated for Abnormal Pap smear

Cancer cases detected

Note: Screening for Cervical cancer were conducted in Bumthang, Punakha, Monggar, Paro, Lhuentse, Trashiyangtse, Trongsa and Gasa.

The screening related to Breast Cancer has been conducted in five districts – Trashigang, Trashiyangtse, Trongsa, Haa and Pemagatshel. The details are reflected as follows:

Screened for Breast Cancer

Procurement of equipment’s and consumables

Procured and installed 10 endoscopy machines for early detection of gastric cancer at: JDWNRH (3); Trashigang Hospital (1); Mongar Regional Referral Hospital (1); Gelephu Regional Referral Hospital; Paro Hospital;  Dewathang Hospital (1); Wangdue Hospital (1) and Bumthang Hospital (1). In addition, viral marker kits re also procured and distributed to the districts conducting the camps.

Similarly, for the cervical cancer screening, Laboratory reagent and consumables for pap-smear are procured and distributed across the health facilities. Besides, to treat the early precancerous lesions, 2 sets of thermacoagulators and 5 sets of colposcopy machines are procured and the colposcopy machines are further distributed to Phuntsholing Hospital, ERRH and JDWNRH.

Procured 2 sets of mammography machines for early detection of breast cancer.

Guideline and Advocacy Materials

In order to roll out the cancer screening project, the cancer screening guidelines for gastric, cervical and breast cancer was developed and made available for all the end users.


Capacity Building

20 health workers (5 Doctors, 13 Nurses and 2 Engineers) were provided training virtually to use/operate endoscopy in collaboration with equipment  supplier to ensure the health workers to comfortably handle the equipment and deliver effective services.

 A week-long attachment program was provided to Nurses working in   Paro, Wangdue Phodrang, Bumthang, Trashigang and Gelephu RRH at Jigme Dorji Wangchuck National Referral Hospital & Monggar Regional Referral Hospital.