Thesis Archive

A System dynamics approach for cervical cancer prevention and control in the Philippines (2010)

Antonio Louis A. Holmes

Abstract:

-According to recent report from the Philippine Obstetrical and Gynecological Society, twelve Filipino women die each day because of cervical cancer. And out of the cervical cancer. And out of the estimated 6,000 new cases diagnosed each year, only 44 percent survive as two-thirds of cases detected are already in the advanced stage of the disease.

This study discussed how cervical cancer has become more prevalent in the Philippines while focusing on the Human Papillomavirus spread and prevalence. In order to fully grasp the variables which affect this, the system dynamics methodology was used. Because there is no existing system for the specific cancer site, a model was formulated to represent how the system would behave through feedback loops present among the variables included in it. This considered the female population, their sexual activity, the technical experts in the field, the use of contraceptives and the influence of media.

The model was ran several simulations to see how its behavior compares with historical data. These behaviors showed the effects of several scenarios through time, with the first run covering the period of 1984 to 2004. The succeeding run covers the next 20 years as it would take into consideration the programs that are implemented, as well as the development in the field of medicine-such as new screening procedures (Visual Inspection with Acetic acid) or prevention methods (vaccine). The sensitivity analysis through changing parameters and adding scenarios have contributed to the validation of the model.

From the base runs and scenarios, several policies were arrived at. The first was to create an incentive program for technical experts to encourage them to venture into this field. This would raise the awareness of people regarding the disease and take away the negative connotation attached to it. The increase of technical experts has proven to increase the number of people who undergo screening, while decreasing those who remain undiagnosed. The second policy is to integrate the use of contraceptives with sexual education. As it is an inevitable fact that majority of the youth would engage in sexual activity, they should at least take responsibility over their actions. One way to avoid the spread of sexually transmitted diseases, as well as pregnancy, is to use contraceptives. By focusing on the younger age group, the issue on the initiation of sexual activity is addressed. This policy decreases incidence and mortality, while limiting the cases of cervical cancer. The third policy is to apply a barangay-based implementation as to make the facilities and services more accessible to the public. This policy ultimately controls the mortality rate of people, combined with conscious efforts in sustaining their budget and costs.

There is a tendency for people to believe that the vaccine would keep them immune from the disease. However, it only covers 80% of the strains of HIV and could also have detrimental effects on the sexual behavior of the youth. This study has shown that even if it has gained much attention and prominence, it is not the best way to prevent and control the spread of the disease. Cervical cancer is not like other cancer sites wherein they are acquired genetically or as a lifestyle disease. It happens though the transmission of HPV, that of which could only occur through sexual activity.

In order to control the behavior of the people, programs should be implemented at a barangay-level to make it more accessible to residents. This would also entail their own monitoring, what has been found as the most important and influential part of the system. Cervical cancer is a disease that takes years to develop, thus, we should take up what is asked of us to prevent it.

Adviser:

Mr. Dennis Beng Hui