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Problem Identification

Cervical cancer is both preventable and curable. Breast cancer is also preventable and curable. Both of these diseases require early detection and sustainable and accessible preventive measures like vaccination and effective precancerous treatments. These cancers affect many women in all social circles, but more so those in the low-income bracket. This is because women from the high economic end have comprehensive health policies that give them access to adequate health care and important information. They often undergo frequent cancer screening on advice from their doctors, unlike their poor counterparts who do not have comprehensive health covers and private doctors. While all women are at risk of breast and cervical cancer, those that are in serious danger from these deadly but curable diseases are the less privileged women. This is why they are the most affected population. This health advocacy campaign’s target population is women living in low-income areas (American Nurses Association, 2012).

A similar health advocacy program was carried out by Breast Cancer Action (BCAction), where the organizations raised funds that helped in the enacting of the California Safe Cosmetics Act of 2005. This two year long advocacy campaign focused on the toxic chemicals in cosmetics, which were considered to be a potentially large part of the environmental causes of cancer. The campaign was effective because it had a short term goal that was not only practical, but also understandable. It focused on raising funds and creating awareness to influence the public opinion (Smith, 2004). 

The National Breast Cancer Coalition (NBCC) also undertook an advocacy mission that aimed to provide free treatment for women in the low-income bracket who had been diagnosed with either breast or cervical cancer. This has been achieved through the CDC (Centers for Disease Control and Prevention). The triumph was achieved by intense and extensive grassroots activism in the state level. The Breast and Cervical Cancer Treatment Act is now effective in all the states (American Nurses Association, 2012).

To curb this issue of breast and cervical cancer among women living in low and middle income areas, a favorable policy is required. This policy’s main objective is to substantially reduce the mortality rates through vaccination, early detection and affordable treatment. Its specific objectives should include:

  1. To facilitate mass sensitization on relevant and accurate information about the cancers;
  2. To ensure vaccination of adolescent girls against the HPV;
  3. To provide cancer screening and vaccination as basic health services at minimal cost or free of charge;
  4. To improve accessibility of the screening, vaccination and treatment services by availing them at the primary health care centers;
  5. To provide care and sustenance for advanced cancer patients.

In solving this problem of high mortality rates due to breast and cervical cancers, the stakeholders involved are health care service providers, hospital, clinic and laboratory managers, top officials in the ministry of health, insurance companies, social security agencies, professional associations, civil society organizations, donor agencies, NGO’s, the private sector, community leaders and media personalities. These stakeholders can be reached through special meetings, and public invitation to community health outreaches. The stakeholders will be informed about the benefits of implementing the new policy in order for them to support it. In this case, they include the following donors, the community and the management.

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Reduced Disease Burden

Breast and cervical cancer are a big burden to the nation economically, socially and even emotionally. Currently, a family with a cancer patient suffers financially as the treatment and care are both very expensive. Providing an insurance cover for these cancers is also expensive for the insurance companies. Trying to provide the required facilities for treating both breast and cervical cancers are expensive and operating them also costs the government a lot of the tax payers’ money. All the stakeholders are affected by the disease in one way or another, thus their cooperation is important in reducing the prevalence and mortality rates (Smith, 2004).

Opportunities of the New Policy

Implementing the new policy will give health care providers the opportunity to promote sexual and reproductive health among adolescents as the policy entails sensitization and information dissemination mechanisms that are effective for reaching the young population.

Reduced Future Expenses

A low prevalence rate for the cancers will translate to fewer expenses on treatment and palliative care for patients in the future. This in turn means that the resources will be channeled to other important areas like education and industrialization. The fact that the policy aims to improve access to cancer screening, vaccination and treatment means that there will be fewer deaths caused by these preventable and curable cancers. Productivity of the womenfolk will not be compromised. This is basically good motivation for all stakeholders as employers and human beings. Currently, almost 300,000 women globally, young and old alike, succumb to cervical cancer alone yearly. This is too much for a disease that is not only preventable through vaccination, but also curable upon early detection. The fact that over half of these women come from middle and low income areas means that it is all upon the government and policy makers to avert this pending crisis. With cooperation from the relevant stakeholders, these policy makers are in a position to change the situation completely (Vlaenderen, 2001).

The policy makers will be informed on issues like how this policy will affect the country’s economy and position in implementing the millennium development goals. A low prevalence rate of the cancers due to vaccination, precncerous treatment and mass sensitization will result in high economies as the productivity of working women is not affected, and there will be a much smaller expenditure for the government in terms of treatment and palliative care for advanced cancer patients.

This advocacy campaign is set for success, because the motivation is genuine. Much attention has been given to post diagnosis, and this campaign seeks to enhance prevention mechanisms. Also, the fact that the recommended policy will result in decreased government expenditure in the future means that more legislators are likely to be interested.

Legal Considerations

This policy can be enacted through modification of the existing health care laws. This is so as to include provisions for free and mandatory vaccination of adolescent girls, frequent cancer screening for the older women and compulsory palliative care for advanced cancer patients. This advocacy has no legal impediments since it is mainly based on existing laws like the universal health policy. The policy seeks to make cancer prevention, treatment and care services accessible to all regardless of financial status.

To gain support for the policy, grass roots activism will be the most used method. The cost of diagnosing breast cancer and vaccinating against cervical cancer is far too high for the women in the low-income bracket. By mobilizing young men and women and empowering them with correct information on these preventable diseases, it is intended to influence public opinion and conduct indirect lobbying. These newly mobilized members of the public are expected to mobilize other members using the information that they already have. This creates a large network of people committed to one cause. This formed network will then organize and participate in marches and rallies that are meant to create mass awareness and increase the number of supporters for the policy.

After creating a remarkable support base, the campaign will take a letter writing direction, whereby the supporters will be required to write to the executive about their concerns with regards to the cost of vaccination and screening for the cancers. A good number of petitions will be written soon afterwards. All these shall be carried out as indirect lobbying. The direct lobbying methods used will include direct contact with the congressmen and testifying in congressional committee meetings.

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Ethical Considerations

Just like any other advocacy campaign, this initiative will focus on the ethical issues that affect the people concerned. The campaign ethics in research involves protecting subjects or the people involved from physical and psychological harm as well as death, and also promoting the right of subjects to refuse participation in the research. The campaign is ethical because it will be reviewed and approved by the institutional ethics committee which only approves trials that meet the ethical standards (Milstead, 2012). This campaign will reflect this by obtaining informed consent from all the people involved and maintaining the privacy of the patients by reporting only aggregate data without disclosing their identities. Furthermore, the campaign will respect every individual’s cultural beliefs to make sure that the campaign does not undermine people’s believes. 

Reporting & Evaluation

Although, evaluation is regarded as the final stage in program design and evaluation, it is applied at every stage. This helps the management and other parties interested in the program to gauge whether the program is headed the right direction or not. Remedial action is taken to make sure that the project meets the targets in time. A program must set and define guidelines on how to accomplish particular outlines in regard to certain groups and classes of clients. That can as well be achieved through evaluation. Through evaluation, the management together with other stakeholders will realize the scope of their achievement. It will help them understand whether they are on the right track or not. Such findings are extremely crucial in project implementation.

To the sponsors, it helps them to account for their money. It helps the management to gauge the performance of their project. In other words, it helps the management and donors to measure the impact that the project has created on the ground. In this project, it would not be easy to assess the success of the program, unless the management evaluates every stage of it. Therefore the design of the program should have a verifying mechanism to certain that actually there is an unmet need in the community. The need identified as far as this project is concerned is the existence of cancer victims. That should include facts and not just mere assertions by the founders of the organization. Under evaluation a person will define the vacuum or the need that is unmet in the community completely.

To perfectly define the need, evaluation must include verifiable objectives and concrete evidence supporting the existence of the unmet need in the community. The design on the other hand should include verifying what objectives need to be met. It must also include what innovative knowledge, abilities and skills within the clients to be achieved. Program evaluation should be conducted from time to time to confirm that the program is headed in the right direction and its goals are being fulfilled.

The activities carried under the program evaluation may be expanded to include a wide range of methods to evaluate as many aspects as possible in programs done under nonprofits. As it is with any evaluation process, the kind of evaluation applied depends on what organization needs to do resulting from the evaluation, whether it is, for instance, to modify the program’s processes or determine the outcomes of the program. There are many methods of evaluations. For instance, a goals-oriented evaluation scrutinizes the status of the program’s goal achievement. A process evaluation checks the weaknesses and strengths of the processes of the program. An outcomes-evaluation exaamines what and hot outcomes were achieved. Although summarizing the data achieved from these types of questions is harder, they provide in-depth information on the preferences of the participants. It is also important that the participants of this survey are assured of their anonymity and that the information they give will be kept confidential. It will help the organizers to get a cover letter from the manager with his or her signature. It will also help to include the employees’ representatives in the formulation of the survey questions. This will allow the committee to remove those questions that may be objected to by the employees. Demographic information will also be necessary at both the beginning and the end of the survey. This demographic information will be necessary when analyzing the data received

Policy

Most properly orchestrated programs often run into difficulties because of constraints during implementation stage. These usually surface as a result of failure to anticipate the complexities of project implementation. For instance, there is the challenge of cost escalation. Most programs run into difficulties during implementation because of escalating prices. Therefore, the core policy in this project is to formulate implementation strategies. The project recommends numerous changes in terms of implementation and execution. 

When implementing a project, a needs assessment should be conducted. This helps to identify and accommodate presently identified needs and those likely to occur in the implementation process. Plans are made underway to help coping with day to day needs and incidental ones like accidents. Criteria are drawn and links established with external agents. In the implementation stage, formative evaluation is conducted whereby data is collected. This data gathers the reaction of the audience concerning the project. It gathers the positive and negative perception of the audience (Heller, 1989)

The implementation process is incremental and ideas are incorporated in the process. It also helps to gather information about the targeted people’s expectations. This helps in the delivery of the final product without facing hostility and rejection from the people. It is always important to meet the people’s expectations, and this can only be done in the preliminary stages of project implementation. Numerous corrections are made from the original plan idea. Performance measurement is also critical in the implementation process. It involves collecting, interpreting and reporting on performance indicators related to how the program is performing particularly in the delivering of goods and services.

Implementation is subdivided in two subtopics that is, formative evaluation and performance measurement. Formative evaluation involves gathering information or data regarding the difficulties associated with or hindering the delivery of the outcomes of the program after implementation. Sometimes alterations have to be done as remedial measures to get the project back to track. This process is sometimes referred to as a remedial evaluation. Formative evaluation also involves collecting data and information regarding the recipients’ reactions to the project and the learning experiences arising from the project prototype or pilot project. The respond to these outcomes consists of the necessary changes required to as discovered through formative evaluation.

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Performance measurement is sampling, interpreting and reporting on performance indicators. This is in relation to how perfect the program impacts the ground in terms of service delivery and achievement of the goals. The process of need assessment analyzes the needs of the program in detail. Assessment will look at how needs are going to be addressed within the program. Like under this program, the assessment will establish how nonprofit care organization will appropriately address the needs of the victims. It will also aim at identifying the characteristics and the nature of the composition of the beneficiaries. The characteristics of the beneficiaries are analyzed in terms of age, sex, educational level among other issues (van, 2001).

Needs assessment determines the available assets in local context on which the target groups can build on. This will help the sponsor to know the best method they might apply to assist the people. Assessment will help those who provide funds and those who directly engage with people on the ground, better understanding the target (Wells, 2007). Knowing the nature of the target in terms of it is their current cultural or financial practices. It provides a clear picture of how the people on the ground live in the community. If foreigners are involved, as it is common in some instances, then they will know in prior the social fabric of the people they want to help.

In most cases the people who deserve help live in very deplorable circumstances. One may find, for instance, that the natures of people who need their services reside in remote places. Program that needs assessment will help a person to have prior knowledge about the people and the environment in which he or she is going to work. When carrying out needs assessment for a program like this, under the principle of participatory research processes, it is important to involve the victims’ families at almost every stage. In assessment, the campaign will be able to tell which other changes to the cancer victims see as important or possible. Campaign should be able to know after the assessment if it will be helpful for them to carry out a pilot project or not.

Conclusion

Due to under-development and poor health services, this campaign may not be as successful as expected because of the nature of the surrounding. There are no government sponsored health facilities. The community is not used to government health facilities.Moreover, most hospitals are privately owned with their peculiar culture and aim to maximize profit. They, therefore, may not want to invest to achieve this. However, the campaign will focus on enlightening the population on the advantages of carrying out regular body inspection.

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