March and May 2018
Cali was the first city to join the City Cancer Challenge in March 2017.
A multisectoral City Executive Committee in Cali provides oversight to the City Cancer Challenge, and includes representatives of the Ministry of Health and National Health Superintendent, Governor, and Health Secretary of the Valle del Cauca Department, Mayor, and Health Secretary of Cali, Cancer Registry of Cali, Civil society organisations: Fundacion POHEMA, Unicancer, Patients Association, Hospital Universitario del Valle, Fundacion Valle de Lili, Escuela de Medicina Universidad del Valle, Centro Médico Imbanaco, Health insurance providers EMSSANAR and SOS and the Association of Private Health Service Providers (ACEMI).
Cali completed a needs assessment for the city, based on the the participation of more than 186 health professionals, cancer patients and advocates. One of the issues identified through the assessment, and prioritised by the City Executive Committee, was the need to strengthen the capacity of the city’s laboratory network – including providing supplementary training on quality control.
To fulfil this need, City Cancer Challenge partnered with the American Society for Clinical Pathology (ASCP) to deliver a series of quality control workshops in March and April 2018, at the Universidad del Valle, School of Public Health.
Santiago de Cali is the capital of the Valle del Cauca department – one of the main economic, cultural, and industrial centres in the country.
Cali is the most populous city in southwest Colombia, with a population of 2.4 million. The city also acts as a centre of reference in the region for patients requiring highly complex healthcare, and therefore serves a wider population of around 9 million people.
According to data from the Cali Cancer Registry, between 2008 and 2012 the highest incidence cancers were breast (2,918 cases), prostate (2,851 cases), colorectal (1,782 cases), stomach (1,779 cases) and lung (1,247 cases), with prostate and breast cancer as the most common cause of cancer deaths in men and women respectively.
More than 60 laboratory professionals representing 23 public and private laboratories in Cali, and the Department of Valle de Cauca, participated in the quality control workshops, developed by ASCP based on its standard training curriculum on quality control management. The workshops were delivered by expert volunteers from the ASCP membership network.
There were 18 modules in total, divided into two separate workshops, held six weeks apart. The workshops focused on the basics of laboratory quality control, with the modules covering a range of issues related to quality control and management for laboratories (including personnel, equipment, purchasing and inventory, facilities and safety, customer service and more).
The quality control training by ASCP was the first concrete technical assistance activity implemented by City Cancer Challenge in Cali. The training was also the first step in helping strengthen the direct relationship between ASCP and local partners. The workshop was supported by local stakeholders, and the School of Public Health of the Univeridad del Valle donated the classroom space.
The training delivered many learnings, helping galvanize stakeholders from the entire range of laboratories across the region – public, private, small and large. The pre and post-assessments show the training was well-received and highly rated by participants.
The partnership was also a great benefit to ASCP, as the modules were translated for the first time into Spanish, and their expert volunteer trainers provided updates and adaptations to some of the content.
A key lesson learned for both local partners and the City Cancer Challenge was the importance of planning for the training with ASCP and their volunteer experts to identify the priority learning needs, including through pre-planning assessment trips. The trainings also helped transform perceptions about the City Cancer Challenge – conducting a concrete technical assistance activity helped improve perception of the City Cancer Challenge as something tangible.
The biggest outcome of the partnership to date is strengthening the network of laboratory professionals in the city, helping to reinforce the value of the City Cancer Challenge process in Cali.
To complement the theoretical training, ASCP is currently planning practical training in four major laboratories in Cali. An expert consultant pathologist and technologist will travel to the region for one to two weeks, with the goal of ensuring all laboratory technologists throughout the network visit one of the laboratories to work directly with the experts.
"As part of the City Cancer Challenge initiative, the Valle del Cauca and city of Cali are working together to improve access to timely treatment and quality cancer care. Building on the commitments and attention that are being generated at a global level, the Valle del Cauca department and its capital city have a unique opportunity to become a model not only for the country, but for the Latin America region in the fight against cancer.” Dr Maria Cristina Lesmes Duque, Departmental Secretary for Health, Valle del Cauca
The outcomes of the training sessions and collaboration between City Cancer Challenge pathology technical leaders and the ASCP, including the development of a technical assistance model, will be replicated and adapted for other City Cancer Challenge Key Learning Cities in 2018/2019.
In the near future, the Cali City Executive Committee is looking forward to further technical assistance activities, currently under development in collaboration with ASCP.
More broadly, priorities requiring high and low resource investment, that can address identified gaps in cancer care, have been defined and agreed for the city. A draft implementation plan is currently being developed by the City Executive Committee.
The City Cancer Challenge will continue to build on this successful model of technical assistance with all Key Learning and Challenge Cities.
*City Cancer Challenge is committed to support 20 cities around the world to take the City Cancer Challenge by 2020. Through the City Cancer Challenge process, cities will conduct a comprehensive needs assessment, identify priorities, and make plans to improve cancer care and treatment for their people.