Cervical cancer is the 4th most common cancer in women worldwide, with up to 85% of the burden in resource-restricted countries. Early detection of precancer has shown to be successful in reducing cancer incidence and mortality. However, a global implementation of this approach is hampered by culture and resource differences between countries. We propose to evaluate the acceptability, feasibility and cost-effectiveness of the ELEVATE cervical cancer screening tool in low-income countries (LIC). The tool is a portable, battery-powered device compatible with self-sampling and comprises an HPV DNA test as well as a proteomic biomarkers detection sensor and will be offered to women in Ethiopia, Cambodia, Mozambique and Uganda. This multidisciplinary consortium, led by Ghent University (Belgium), brings together social scientists, health economists and biosensor experts from Europe and the selected countries with industry partners. The approach is three-fold: social science investigations will be conducted to understand current screening practices and to define a tailored strategy, including the ELEVATE tool, embedded in the current health system. Secondly, engineers will validate the self-testing device and will adapt it to reduce the unit price and to enable large-scale manufacturing at an affordable cost. Finally, public health specialists and health economists will evaluate the implementation of the new screening tool to assess its appropriateness and cost-effectiveness. For the latter objective, an intervention will be implemented: in the first arm, the different steps of current cervical cancer screening practices will be optimized (awareness, pre-and post-counseling and referral). In the second arm, the same strategy will be applied in combination with the new point-of-care screening device. Integral part of CHILI is to maximize the use of the new screening tool in low-resource settings in collaboration with national stakeholders and health care providers.

Two important elements of healthcare workforce development are access to information and quality higher education. Health sciences staff, students and healthcare professionals in low- and middle-income countries lack access to high quality health information adapted to their specific needs. Access to high quality education becomes more important for future healthcare professionals, amongst others because an accelerating digitalisation needs matching digital competencies. In Indonesia and Cambodia, these problems are excacerbated respectively by a spread-out geography and a challenging economical situation. Both countries want to enhance quality of their Higher Education (HE) and improve university support services.This project addressses the above needs by:1) Building up the capacity of techno-pedagogical staff, so they can assist teaching staff in implementing innovative techno-pedagogical projects in teaching & training2) Building up the capacity of health libraries and specialized librarians, so they can improve service for HEI staff & students and train them in digital information management skills 3) Ensuring open access to high-quality scientific and educational resources for HEI staff & students and healthcare professionals, via the development of platforms and supporting teaching and academic staff in posting high quality content on these platforms. The content will also be exploited by healthcare professionals. The impact of this project will be sustained beyond the project end, by (1) making sure that training is tailored to the needs of the HEIs; (2) subscribing to the vision and the strategy of the partner HEIs and (3) ensuring co-ownership of all digital platforms through a network of experts from Partner HEIs. The innovative platform will focus on infectious and (neglected) tropical diseases as a case study, given the specific expertise of all consortium partners. As such, this project aims to improve HE and ultimately healthcare quality in SEA.

Background. Diabetes and hypertension are increasingly dominant in the global burden of disease. Effective interventions for prevention, detection, treatment and control of both conditions are available, but do not reach all people in need. Countries are struggling how to scale-up interventions sustainably and effectively. There is an urgent need to develop and document strategies on how to do so. Method. This project examines the scale-up of existing evidence-based packages for control of diabetes and/or hypertension with five components: (a) identification of people with HT and/or T2D and (b) treatment in primary care services, (c) health education and (d) self-management support to patients and caregivers, and (e) collaboration among caregivers. The project develops, implements and evaluates roadmaps for the national scale-up of this package, in three different types of countries: a low-middle income country with a developing health system (Cambodia), a former socialist country with a centralised health system (Slovenia), and a Western European country with a decentralised system (Belgium). The research objectives are: 1) to analyse the organisational capacity to scale-up the integrated care package and to assess contextual barriers and facilitators; 2) to develop and implement roadmaps for a national scale-up strategy in each country; 3) to evaluate the impact of scale-up on health outcomes and costs; and 4) to generate lessons for other countries. Outcomes. The project will result in comprehensive scale-up strategies and increased diabetes and hypertension control in each country. The involvement of policy-makers, professionals and patients will ensure the local relevance and impact. The project is innovative in applying the conceptual insights from scale-up science to the field of noncommunicable diseases. The lessons on scale-up will benefit policy-makers in other countries with similar contexts.