Bristol-Myers Squibb Foundation Secure
the Future
Technical Assistance Programme
(BMSF STF TAP)
&
Swaziland Breast and Cervical Cancer Network
(SBCCN)
REGIONAL FOCUS:
SCOPE OF PARTNERSHIP:
Swaziland : Manzini, Hlathikhulu and Mbabane,
To conduct training for SBCCN on leadership and governance; Awareness
Education, Monitoring and Evaluation, Data Management and capacity
building in HIV/Oncology partnerships.
OBJECTIVES:
To create an on-going training system in rural Swaziland to empower
communities on breast cancer, cervical cancer and HIV awareness and
increase knowledge on prevention, screening and early detection.
VALUE OF ASSISTANCE:
US$ 73,076.75
18 months
PERIOD OF ASSISTANCE:
BACKGROUND
Swaziland Breast and Cervical Cancer Network (SBCCN) is one of the principal providers of breast and
cervical cancer services to the population of Swaziland. SBCCN operates three breast cancer clinics which
offer free consultations, examinations, diagnosis and referrals in Manzini City, Hlathikhulu Government
Hospital and Mbabane Government Hospital. It has also established screening services for cervical cancer at
the same centre’s. The clinics use Visual Inspection with Acetic Acid (VIA), a quick diagnostic method, along
with cryotherapy to detect suspicious cells.
INITIAL PARTNERSHIP
Prior to the partnership with BMSF STF in 2010, SBCCN did not have an independent strategy for reaching
out to communities with awareness messages about on testing for breast, cervix, prostrate and testicular
cancers. SBCCN’s approach was to lurch onto campaigns by peer organizations, partnering with them to
educate and screen for the diseases using the clinical and self breast examination methods. BMSF TAP
assistance provided SBCCN the opportunity to work autonomously. The organization explored virgin territory,
in Ngculwini Village, where they were able to monitor and track the success of their project without the
influence of other health interventions.
The thrust of the collaboration was to provide capacity for SBCCN in Leadership and Governance; Data
Management; Awareness Education, and Monitoring and Evaluation.
Technical assistance is provided to the organization at executive and volunteer level. Training commenced at
the inception of the partnership with assistance on leadership and governance for the board of directors. The
role of the board was clarified and strengthened to the end that the executives now undertake an active role
in the formulation and implementation of a variety of fundraising strategies to complement available
resources. They actively participate in creating visibility for SBCCN initiatives and facilitated the recruitment
of the Executive Director.
BMSF STF followed up the board’s initial training with further TAP assistance on the review of financial
performance to enable the board members to determine areas requiring resources and implementation of a
diversified approach to resource mobilization.
Technical assistance on community mapping, mobilization and monitoring and evaluation for SBCCN staff
and volunteers is provided on an ongoing basis. TAP was also provided on the development of a strategic
action plan for HIV and breast/cervical cancer education and healthcare. The plan offers various innovative
approaches to create awareness, screen, treat and prevent the cancers. For example, SBCCN uses cancer
survivors to spread messages on the diseases and Training of Trainers (TOT) for Rural Health Motivators
(RHM).
SBCCN’s vision is to establish an oncology unit to provide chemotherapy programmes for patients within the
borders of Swaziland. As they press towards this ultimate goal, they focus on the immediate workable
strategy to develop the capacity of medical personnel to manage breast and other cancers through
workshops, seminars and attachments to oncology units of health services sectors in South Africa.
EXTENDED PARTNERSHIP
SBCCN is consolidating and extending the RHMs’ training programme on HIV/Oncology that was initiated in
Ngculwini. The pilot programme revealed that greater capacity in screening for cervical abnormalities at
community level would also significantly benefit the population in that region.
In the replication programme, SBCCN is training a group of clinic staff in Visual Inspection with Acetic Acid
(VIA), which is a well-established, inexpensive, instantaneous method for assessing cervical abnormalities.
THE RESULTS

Policies and operational systems and procedures have been developed and implemented to facilitate
the work of the SBCCN.

Awareness has been raised on the various aspects related to breast cancer, including the increasing
incidence of the disease, promotion of breast self-examination, annual medical examination and the
importance of early diagnosis and treatment.

A patient referral tool has been developed.

Trans-border relationships have been built with partners in South Africa to consult with and train
nurses and doctors for the diagnosis and treatment of breast and cervical cancer.

Thirty two (32) health providers, 8 nurses and 24 RHMs, were trained on HIV/AIDS and its
relationship with breast and cervical cancer.

One thousand community members (700 hundred school children and teachers; 300 church
members) received direct awareness and sensitisation on HIV/Breast Cancer/Cervical Cancer from
the SBCCN Awareness creation Team

550 community members from 90 homesteads at the Ngculwini community were educated by the
trained RHMs. 76 of the women were counselled to be screened for HIV as they presented HIV
related conditions.

The only clinic in the community was capacitated to provide comprehensive HIV management
(integrated with breast and cervical cancer education) for the community.

Income Generating Activity where the women make beaded breast cancer ribbons was set up for
women in the community with 13 women in the pilot project.

Breast and cervical cancer awareness and screening campaign conducted at Ngculwini community
with 123 people screened (4 males and 119 females) for breast cancer and 1 screened for cervical
cancer. The lady screened for cervical cancer is also HIV positive.
LESSONS LEARNED

Using clinic staff and RHMs was effective in channeling campaign messages. 70% of the community
members received information about HIV and breast/cervical cancers from the community clinic
and/or the RHMs.

The use of the RHMs is a best practice in that RHMs already exist within the government health
delivery structure and receive a stipend from Government. Consequently, the project did not have to
pay for their services, making the strategy more sustainable.

People now find the need to know their HIV status to help avert contraction of further disease that
may occur due to the break down in the immune system, since they are now aware of the link
between HIV and breast/cervical cancer. Seventy-six (76) out of the 300 people educated tested
positive after being screened.

Electronic media are an effective way to mobilize the community. 90% of community members who
attended the community breast cancer screening said they heard about it through radio and/or
RHMs.

Good collaboration with the chief of the community who mobilized his community elders to support
the project ensured good community acceptance and participation in the community activities.