Since 2009, FIRE has been supporting the Mongolian Ministry of Health (MoH) to prevent and diagnose viral hepatitis and liver cancer across Mongolia. FIRE’s strategic, multi-layered programs are implemented with various stakeholders at every level. These programs are designed to be replicated not only across Mongolia, but hopefully anywhere, empowering individuals and health care systems to end this epidemic.
Screening and Testing
In 2011, FIRE began conducting viral hepatitis testing and liver cancer screening programs in rural Mongolia. In 2016, this project was one of five international programs recognized by the World Health Organization (WHO) and European Association for the Study of the Liver (EASL) for innovative hepatitis screening programs. In 2017 it was featured in the Economist Intelligence Unit three times.
This project has been developed and refined through nine implementations in seven provinces of Mongolia since 2011. At each new implementation, services were added and adjustments made based on community needs, input and lessons learned.
A team of Mongolian specialists consisting of hepatologists, an oncologist, ultrasound and FibroScan specialists visited every health clinics in the province to provide the following free services:
Step 1: Rapid serum test for viral hepatitis B and C.
Step 2: Vaccination for HBV started as needed.
Step 3: Those positive for HBV or HCV had an ultrasound exam.
Step 4: Those with liver lesions were tested for AFP and were seen by an oncologist.
Step 5: Those with signs of cirrhosis during the ultrasound exam were given a FibroScan and were seen by an hepatologist.
Step 6: Those who tested positive for HBV or HCV but no indication of current cancer or cirrhosis were seen by an hepatologist.
Step 7: Two hepatologists and an oncologist physically examined and counseled participants on their medical condition, follow-up treatment steps, physician referrals for treatment, information pamphlets and necessary lifestyle changes.
Specialists counsel the participants on their medical conditions, future care and follow-up treatment. This includes discussing and sharing pamphlets regarding treatment options, physician referrals, proper nutrition, how to live a healthy lifestyle, how to prevent further transmission, and “how to love the liver.” Doctors write examination results in the patient’s record book.
Hepatitis B Vaccination
Since 2011, FIRE has been vaccinating health care workers in rural Mongolia. The hepatitis B vaccine not only prevents hepatitis but also liver cancer. FIRE continues to vaccinate health care workers who test negative for hepatitis B and have not previously been vaccinated. Vaccinations are also given to participants of FIRE’s Viral Hepatitis and Liver Cancer Screening Project who test negative for hepatitis B.
Health Care Worker Capacity Building, Community Awareness, and Advocacy
Our large screening projects are also done in conjunction with Community Awareness Events, Health Care Worker Capacity Building. We also include Infection, Prevention and Control activities when the budget allows.
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