Every Woman Matters Program
Early detection of breast and cervical cancer reduced the burden of disease in women. The practices of Screening shown reduce the level of mortality and improve quality of life. The Every Woman Matters (EWM)stared in 1992 it is a federally-funded program designed to remove barrier to early screening by providing awareness and make screening more financially accessible to woman who have limited or no health insurance.
The eligible women receive pay for office visits with associated clinical breast examination, pelvic examination, Papanicolaou smear test, and lab fees (Backer et al., 2004). Age-appropriate mammography and limited number of diagnostic test is also covered under program. In this paper I will discuss the possible reason of program ineffectiveness, preventive programs that advocate the early screening and strategies to create more effective preventive program. Reasons of Program Ineffectiveness
There are multiple reasons which make the program ineffective such as complex organization systems, practice diversity in their missions, the different individual personalities of heath care providers, their organizational flexibilities, the availability of resources to practice and the control they have on their use, and their leadership and team work abilities, moreover staff resistance to add more efforts required for change (Backer et al., 2004). Preventive Program that Advocate Early Screening
The Icelandic screening program was started in November 1987 till 2010. The program purpose was to evaluate the efficacy of the screening program. The cost effective mammography was provided with cervical cancer screening all women aged 40-69 was invited, 33,985 women in 1988 and 54,714 in 2010 under gone screening program with the two year intervals.
All mammograms are read at the Cancer Detection Clinic (CDC), women with abnormal screening findings are recalled for further workup, like ultrasound examination, and needle biopsies before decision of further referral. This study confirmed a 41% decrease in the mortality rate for all age group after the start of screening. This was population based study of 22 year screening period and considered as a main strength of the study which makes it successful. (Sigurdsson & Olafsdottir, 2013)
Center for Disease Control and Prevention (CDC’s) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides access to breast and cervical cancer screening to underserved women in all 50 states. NBCCEDP programs use population-based approaches such as public education, patient navigation, and outreach, care coordination to increase screening and reach underserved and uninsured populations. This program provides cervical screening for 21 to 64 year and breast screening for 40 to 64 years. Since this program initiated in 1991 almost 3.7 million women has been screened and 44,885 cases of breast cancer, 2,554 cervical cancers and123, 563 cervical precursor lesions have been detected (Benard et.al , 2011).
NBCCEDP use Conceptual Framework supports a collection of strategies to reach uninsured women, including program controlling, screening and diagnostic services. Team members of the NBCCEDP work collaboratively to provide breast and cervical cancer screening, diagnostic evaluation, treatment and referrals. “The program’s continued success depends in large part on the complementary efforts of a variety of national partner organizations, as well as on state and community partners” (CDC, 2012). The key success for these two cancer screening programmes is; the target disease breast and cervical cancers are common form of cancer with high associated morbidity or mortality. Effective treatment is provided, which is capable to reducing morbidity and mortality. Test procedures are acceptable, safe, and comparatively inexpensive (WHO, 2013).
Strategies for Effective Preventive Program
If I will get chance to be nurse leader in charge of Every Woman Matters program, I will propose following strategies to create more effective prevention program. Community involvement in planning and implementation of the program has vita role this approach let the community people to assess their own health care needs and develop implementation strategies to address the needs. Community directed programs depend on community perception about existing barriers and approaches to address these barriers and increase cancer prevention and screening. Join planning of the community and contribution in all parts of the program permits ownership of the program by the community members (Wolff, 2003).
The underserved communities who are still deprived from the standard delivery of health care services many alternative methods can be used to reach this group. Mass media programs, videos, broachers, T-shirts with health care massages can use as educational material. Moreover pictorial presentation of the steps of taking Mammogram can be used to educate uneducated and low income women. Social network or social influence interventions is also very effective for cancer prevention program. The community people who have been refer as more credible member of the community such as trusted and influential members can be used to communicate cancer prevention and screening massages (Wolff, 2003). Summery
Every Woman Matters is a federally-funded program that works on early screening for breast and cervical cancer. Despite the barriers number of screening is significant increases in several of the practices. More strategies need to add to make the program for effective and reach under served and uninsured women.
Backer, E. L., Geske, J. A., McIlvain, H. E., Dodendorf, D. M., &Minier, W. C. (2005). Improving female preventive health care delivery through practice change: An Every Woman Matters study. Journal of the American Board of Family Practice, 18(5), 401–408. Sigurdsson, K., Olafsdottir, E. J. (2013). Population-based service mammography
screening: the Icelandic experience. Dove press Journal, 5 17–25 Wolff, M et.al (2003). African American Communities: Barriers and Effective Strategies-A
Review of the Literature. Wisconsin Medical Journal, 102(5), 36-40. Benard, V .(2011). Cancer Screening Practices Among Physicians in the National Breast and Cervical Cancer Early Detection Program Journal of Women’s Health 20(10):1479-84 doi: 10.1089/jwh.2010.2530. Epub 2011 Jul 20 Centers for Disease Control and Prevention. Cancer screening—United States, 2010. MMWR
World Health Organization. (2013).Screening for various cancers. Retrieved from