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Maria Teresa Gonzalez de Andrade

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Cruzada de la Esperanza (Crusade of Hope)

Women’s Health Promotion and the Prevention and Diagnosis of Breast Cancer, Cervical Cancer, Uterine Cancer, and Sexually Transmitted Diseases in Rural Honduras, 2008-2009

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A pilot public health project in Honduras aimed at providing services for women’s health promotion and the prevention and diagnosis of breast, cervix and uterus cancers, sexually transmitted diseases and HIV/AIDS was implemented. “Cruzada de la Esperanza” targeted 789,415 women of fertile age older than 18 years in impoverished and hard to reach rural areas. The project was funded by The Democratic Republic of China-Taiwan and The Honduras Health Ministry. “COCSIDA” Centro de Orientación y Capacitación en SIDA (Center for Counseling and Training on HIV/AIDS) was the institution administrating and implementing the project in 98 municipalities and 576 villages. The health threats in this population are due to the close relationship between women’s reproductive health issues and components of human sexuality, influenced by socio-cultural factors expressed through male “machismo”, female subordination and lack of empowerment and education. The project’s demographic coverage was every person who directly or indirectly benefited from the services. The criteria for intervention were those for the targeted health threats and pregnant women. The Crusade’s main goal was to decrease late detection for the stated cancers and other health problems. Another goal was the increase of access and services utilization including mammography, vaginal cytology, rapid HIV testing and counseling, diagnosis of sexually transmitted diseases and positive case referral to a higher quality health care center. By achieving the above goals the Honduras female population was educated to adopt better and safer health care practices and access to those services will increase. The main strategy of implementation was the use of 3 mobile mammograms, radiological and laboratory diagnostic equipped vehicles available in a community health fair atmosphere. The plan was to provide 10,800 mammograms, 25,920 ultrasounds, 25,920 vaginal cytologies, 12,920 rapid HIV tests and 20,000 sexually transmitted disease attentions. The Crusade began in May 2008 but ended in March 2009. A total of 98 municipalities in 13 departments and 263,242 people were serviced. A total of 330,154 attentions out of 312,736 planned (105.6%) were accomplished. Of these, 15,390 were mammograms, 9,187 were ultrasounds, 27,271 were cytologies, 13,681 were rapid HIV tests and 8,808 were STD attentions. 305 vaginal cytologies and 70 mammograms were suggestive of malignancy. 21 cases were HIV-positive. 100% of the suggestive malignancy and HIV cases were referred and inserted in a specialized institution for medical care. Due to the successful results, the funding donor entities granted one more year of activities, sadly canceled due to the Honduran political crisis.

Cruzada de la Esperanza

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Cruzada de la Esperanza, women's health, rural Honduras

Dr. Eduardo Gonzalez Martorell and Maria Teresa Gonzalez de Andrade of COCSIDA discuss a pilot public health project in Honduras aimed at providing women’s health services.

“Cruzada de la Esperanza” (Crusade of Hope): Promotion, Prevention and Diagnosis for Breast, Cervix and Uterus Cancers, Sexually Transmitted Diseases and HIV-AIDS in Honduras Rural Areas 2008-2009

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A pilot public health project in Honduras aimed at providing services for promotion, prevention and diagnosis of breast, cervix and uterus cancers, sexually transmitted diseases and HIV-AIDS was implemented. “Cruzada de la Esperanza” targeted 789,415 women of fertile age older than 18 years in impoverished and hard to reach rural areas. The project was funded by The China-Taiwan Republic and The Honduras Health Ministry. “COCSIDA” Centro de Orientación y Capacitación en SIDA (Center for Counseling and Training on HIV–AIDS) was the institution administrating and implementing the project in 108 municipalities and 576 villages. The health threats in this population are due to the close relationship between women’s reproductive health issues and components of human sexuality; influenced by socio-cultural factors expressed through male “machismo”; female subordination and lack of empowerment and education. The project’s demographic coverage was every person who directly or indirectly benefited from the services. The criteria for intervention were those for the targeted health threats and pregnant women. The Crusade’s main goal was to decrease late detection for the stated cancers and other health problems. Another goal was the increase of access and services utilization including mammography, vaginal cytology, rapid HIV testing and counseling, diagnosis of sexually transmitted diseases and positive case referral to a higher quality health care center. By achieving the above goals the Honduras female population was educated to adopt better and safer health care practices and access to those services will increase. The main strategy of implementation was the use of 3 mobile mammograms, radiological and laboratory diagnostic equipped vehicles available in a community health fair atmosphere. The plan was to provide 10,800 mammograms, 25,920 ultrasounds, 25,920 vaginal cytologies, 12,920 HIV tests and 20,000 sexually transmitted disease attentions. The crusade began in May 2008 but ended in March 2009. A total of 102 municipalities in 13 departments and 263,242 people were serviced. A total of 330,154 attentions out of 312,736 planned (105.6%) was accomplished. Of these, 15,390 were mammograms, 9,187 were ultrasounds, 27,271 were cytologies, 13,681 were HIV tests and 8,808 were STD attentions. 305 vaginal cytologies and 70 mammograms were suggestive of malignancy. 21 cases were HIV positive. 100% of the suggestive malignancy and HIV cases were referred and inserted in a specialized institution for medical care. Due to the successful results, the funding donor entities granted one more year of activities, sadly canceled due to the Honduras political crisis.

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