This screening and awareness program supports the World Health Organization’s Global Health Strategy to eliminate viral hepatitis by 2030. This project will be implemented in Dornod province which has the highest rate of liver cancer in Mongolia. Dornod has twice the Mongolian average of liver cancer, making it 12 times higher than the international average. This project will help undiagnosed, high-risk individuals learn their health status, teach them to prevent disease transmission and provide resources to save and change their lives.  It will reach every community in this province and be conducted in October and November 2016.

Screening and Testing

We work with primary health care providers to invite high risk individuals to our event. Specialists are brought from Ulaanbaatar, including an ultrasound specialist, hepatologist (liver specialist) and oncologist.

Participants proceed through the following steps:

Step 1: Participants are tested for viral hepatitis B and C.

Step 2: Participants testing negative for hepatitis B are given the hepatitis B vaccination.

Step 3: Participants testing positive for hepatitis B or C are examined by an ultrasound specialist and further blood testing as needed.

Step 4: Participants are physically examined and counseled by an oncologist or hepatologist.

Counseling includes explanation of medical conditions, future care, follow-up treatment and physician referrals; sharing pamphlets regarding treatment options, proper nutrition, transmission prevention, and necessary lifestyle changes.

Community awareness events are conducted locally. They include information booths and activities for all ages. They are fun, well attended and family oriented events.

Training of local doctors is conducted for two doctors from every clinic and hospital in the province by the visiting specialist. Through both “shadow training” and accredited classroom sessions, doctors are taught how to prevent, detect and treat viral hepatitis and liver disease.

Advocacy with local community and business leaders provides them with ways to bring both the logistics and financial influences of the community together to implement further solution-based, inter-sector programing.

Knowledge, Attitude and Practice (KAP) survey will be done with 1,000 community members to provide valuable information to insure the most impactful design of future programs and material. It will also provide a basis for evaluation of the project.

Sustainability

This project ensures long-term sustainability by:

• Encouraging local ownership by partnering will all the national stakeholder organizations, government organizations and local community and business leaders
• Training local doctors to continue the work long after completion of the project
• Comprehensively educating patients on the steps they need to take to save their lives
• Provides a lifetime of prevention against hepatitis B by vaccinating participants
• Educating thousands of community members through awareness events and mass distribution of pamphlets about these vital issues and steps necessary to protect and help themselves
• Supporting construction of the government’s database for long term support of patients
• Supporting the World Health Organization and Mongolian Ministry of Health and Sport’s policy development through the KAP survey

Expected Outcomes

This multi-faceted, strategic program will comprehensively address many issues. The expected results are listed below

• 5,000 people will be tested for viral hepatitis B and C
• 1,500 people will be tested for liver cancer through a blood test and ultrasound examination
• 3,500 people will be vaccinated against viral hepatitis B
• 10,000 people will be educated through community awareness activities
• 50,000 information pamphlets and posters will be distributed across the province
• 6,000 patient record books, complete with relevant hepatitis and liver cancer prevention and treatment information, will be distributed
• 400 copies of “Physician’s Guide to Viral Hepatitis,” will be printed and distributed to local doctors
• 50 local doctor will be trained through intensive, hands-on “shadow training” of visiting specialists as they examine and counsel participants and in classroom sessions for educational credits     
• 16 health care facilities will be visited (all the public facilities in the province)
• 30 government and private sector leaders will attend an advocacy meeting to learn about the urgency of this epidemic and ways they can help support its elimination
• 1,500 individuals (an estimated 30% of the total population screened) will  be diagnosed with at least one of a variety of illnesses, giving them the ability to change and save their lives.
• 1,000 people will be given a Knowledge, Attitude and Practice (KAP) survey to test their awareness level of hepatitis. This will provide both important baseline information to help design future  policies and measure the effectiveness of this project.
• A variety of information will be collected from all 5,000 participants and given to the Mongolian Ministry of Health for entry into their database for hepatitis and liver cancer patients.