RESUMEN
This article delves into Bhutan's adept execution of a nationwide cancer screening initiative within the Health Flagship Programme, concentrating on gastric, cervical, and breast cancers. Despite challenges like the COVID-19 pandemic, infrastructure constraints, logistical complexities, health human resource shortages, and data management issues, the programme succeeded. The procurement and logistics management ensured the timely provision of essential medical equipment and test kits. Robust political commitment, a comprehensive advocacy programme, and community engagement were pivotal for the programme's success. Impressive screening coverage for all three cancers showcased the transformative impact on cancer care, integrating technology and fostering community involvement. Recommendations highlight the need for strengthened integration, strategic approaches, and ongoing evaluation, positioning Bhutan's programme as a potential model for nations facing similar health challenges.
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COVID-19 , Detección Precoz del Cáncer , Humanos , Bután/epidemiología , Femenino , COVID-19/epidemiología , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/epidemiología , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/epidemiología , Masculino , Persona de Mediana Edad , Tamizaje Masivo , AdultoRESUMEN
OBJECTIVES: The unmet needs of contraception can lead to unintended pregnancy and transmission of sexually transmitted infections (STI). Therefore, this study aimed to evaluate the contraception use, knowledge, and attitude on STI among students under Royan University of Bhutan (RUB). METHODS: This was a cross-sectional study using an online questionnaire. The questionnaire was developed in Google forms and the link was shared through the college WeChat groups. The questionnaire consisted of four parts on socio-demographic, sexual behaviour and contraceptive use, knowledge, and attitude on STIs. All the students under RUB were invited to participate voluntarily in this study. The socio-demography was presented in frequency and proportion. RESULT: A total of 1,283 students participated in this survey and 55.0% (701) were females. Of this, 29.4% (377) were sexually active and 94.4% reported using modern contraception. Commonly used contraceptives were: condoms (83.8%, 316) and emergency contraceptives (20.6%, 78), respectively. The mean knowledge and attitude scores on STI were 9.94 (range 2-20) and 12 (range 2-14), respectively. Good knowledge and attitude on STI were reported in 53.2% (683) and 70.1% (899) of participants. CONCLUSION: Students reported average knowledge and a good attitude towards STI. Contraceptive use among university students was low. There is a need to strengthen health education on STIs in schools and universities. All forms of contraceptives especially condoms should be made easily available to sexually active people.
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Anticonceptivos , Enfermedades de Transmisión Sexual , Bután , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Embarazo , Conducta Sexual , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/prevención & control , Estudiantes , Encuestas y Cuestionarios , UniversidadesRESUMEN
BACKGROUND: Knowing the number of persons at risk for sexually transmitted diseases (STDs) and their risk behaviors are needed to allocate limited resources, set targets for prevention and care activities, gauge the reach of programs, and assess their impact. Female sex workers (FSWs) are a population at high risk for STD worldwide; little is known about FSW in Bhutan. METHODS: We conducted a community-based survey and population size exercise of FSW in Bhutan. The survey used a hybrid venue-based/peer-referral sampling method. Population size estimation methods were key informant mapping, census and enumeration, unique object multiplier, and capture-recapture. RESULTS: Of 517 women surveyed, 67.5% provided sex for money in the last year. Compared with FSWs at venues, FSWs referred by peers were more likely to have sex with alcohol (80.1% vs. 51.5%, P < 0.001) and more paying partners (mean, 3.5 vs. 2.0; P = 0.001), and less likely to have tested for an STD (28.3% vs. 51.0%, P < 0.001) or have outreach worker contact (27.6% vs. 41.5%, P = 0.007). The estimated number of FSWs in the 9 districts was 353 (95% confidence interval, 345-362). Extrapolation to the whole country projected 597 (417-777) FSWs nationally. CONCLUSIONS: Our estimate of the number of FSW in Bhutan corresponds to 0.71% of adult urban women, a figure in line with other countries in South and Southeast Asia. Our data highlight the need for outreach beyond venues where women are employed to reach FSW at higher risk for STD but who have less access to interventions.