Timely detection of cervical cancer in communities.

Cervical cancer is the second leading cause of cancer death in Mexico, every day between 11 and 13 women die from this disease, despite the fact that it is the only preventable cancer, 20% of cases are detected at an advanced stage. 1 in 3 sexually active women will be diagnosed with HPV and 10% of these will be at risk of developing cancer.

The State of Mexico represents more than 10% of cervical cancer deaths in our contry, being this a major public health problem, and it is the entity with the second highest prevalence of cervical cancer in Mexico, only after Mexico City.

Cervical cancer is the second deadliest cancer in México, only after breast cancer; however, the former is preventable. Our country has over 13K cervical cancer cases per year. Limited access to facilities and specialists results in high prevalence of the infection. Unfortunately, new cases are mostly in an advanced clinical stage and they have a much higher prevalence among lower income segments of the population, due to the lack of good facilities and proper medical care.

This disease is detected and prevent with pap smears and colposcopy, however, we face limited access to these. In Mexico there are two health services: public and private. The public is saturated and the services are inadequate. The private service provides care at costs that are not accessible to the majority of the population, since only 5% have medical expenses insurance.

The care prevention in public health institutions is deficient, it takes more than 20 weeks between diagnosis and treatment, we have managed to reduce it to 4 weeks. Public institutions do not have a system that allows them to monitor or deliver the results to the patients, many times the patients undergo the study, but they never receive their results

In the face of this health crisis, the right time to act is now. Prevention is the cornerstone for reducing the number of diagnoses for cervical cancer, since if HPV is not detected on time, it will turn into cancer and treatment will require cancer care, to which there is no public service access in our country. Causing an increase in the incidence of cervical cancer and in the mortality of Mexican women due to the lack of health services.

We would like to implement “Colposcopy and pathology of the lower genital tract free campaings”  We expect to benefit approximately 4,500 women at the base of the socioeconomical pyramid, and who would otherwise never had the proper screening and treatment, because most of these women are in a very vulnerable situations, they are migrants, most of them have been rapped and kidnapped, also young ladies who suffered human trafficking. 

The long-term benefits are:

● Reduction in morbidity and mortality specially among marginalized women.

● Prevent HPV complications and detect precancerous injuries on time and avoid risk factors.

● Promote a culture of prevention and screening among marginalized communities.

Our project is comprehensive, we do not only screen, diagnose and treat our patients. We also follow up on them and emphasize the importance of yearly check-ups. It is important to mention that in Mexico public health care institutions do not follow up with the patients regarding delivery of results. We put special focus on making our patients with positive results aware of the risks and potential treatments.

This is possible thanks to our IT team that developed an exclusive system for colposcopy and papanicolaou studies. This system contains all the necessary information so that doctors can safely control both the study and the treatment performed on the patients. Also automates the sending of results by SMS and by mail to the patients, which allows none of them to be left without the result of their studies, likewise it uses traffic lights so that the doctor can locate those healthy patients (green) and those patients with low (yellow) and high grade injury (red). It allows us to create a dashboard to know the behavior of our patients, for example, of the total number of patients who left with an injury, how many of them decide to have a biopsy and  how many are treated for the lesion, this allows us to generate reports and make decisions that allow us to ensure that 100% of our patients are treated and prevent their lesion from becoming cancer.

Our solution serves low-income patients, more than 80% have a family income less than 600 usd, 94% do not have access to health services because they live in communities far from health centers or do not have access to public services, more than 20% have never had a gynecological check-up and almost 80% have children.

We also work with associations that serve women with a vulnerable situation such as domestic violence, prostitution, victims of trafficking and kidnapping.

We have an interdisciplinary team that has more than 5 years of experience in supporting communities and vulnerable populations, their ability to resolve, their passion for helping those who need it most, and their experience in the field, allow projects with a social impact to happen with success

Alejandra Silva Anaya / Gerente de Impacto Social

Communications specialist in areas related to Social Responsibility, She will be the project leadership, be in charge of the budget and the alliances with the associations involved in the project, she will look for its sustainability and scalability so that it lasts.

Ximena Diaz Morales / Social Impact Coordinator

Specialist in social impact measurement. She will establish the monitoring and evaluation strategies, ensuring that all impact indicators are met and that the project meets the planned specifications and established objectives.

She is the key piece of communication with the comunities to ensure medical care services for 100% of the patients, that is, she coordinates the calendar with the community and fill the spaces with the women who need it most

Darinka Gallegos / Doctor Specialits in colposcopy

Specialist in Colposcopy, she will be the one who travels to provide pap smears and colposcopy services, in the same way she will be the one who follows up the results of the patients with the pathology area to have the timely diagnosis, she will be the one who cares for patients with altered diagnoses to ensure timely treatment for each of them

More than 5,000 women.

This is a project that started in 2019, due to a pandemic we stopped for a year, however, in 2021 we returned with much more strength. We are interested in applying to Solve because it seems to us to be a platform with many strengths that will undoubtedly allow us to acquire knowledge and skills to scale the project and make it sustainable and increase the impact.

In the same way, this project inspired us to create the Grupo Reina Madre Foundation, a non-profit organization that will allow us to generate more projects with impact. We are sure that Solve will give us the necessary advice so that the foundation works and starts with all the success it need to increase results and reach more communities in need.

Our commitment to Mexican women in vulnerable situations is huge, however, sometimes we do not have the resources to be able to implement our projects with the impact that we would like, Solve can bring us the skills to achieve it.

Firts of all, to provide timely monitoring of each patient, Reina Madre makes available the Colposcopy System developed for its clinics. This system allows the results of each study carried out on patients in each of the consultations they attend to be concentrated in a single place, which allows doctors to concentrate their patients' clinical records in a single space. In Mexico, the public health system does not have the necessary technology to digitize the patient's file, so it is managed physically, with which there is a risk of losing or damaging it, thus losing timely follow-up and efficient of each woman. On the other hand, the Colposcopy System avoids the possibility of this type of accident and also contributes to reducing the use of paper.

It is true that in Mexico there are different associations and government institutions that carry out free gynecological campaigns, however, these consist of performing only the Papanicolaou, they do not carry out colposcopy, biopsy or treatment. This system leaves all women in a situation of vulnerability, especially those who present some alteration in their studies, since they do not have the possibility of carrying out additional studies that confirm the existence of any injury, much less receiving timely treatment; leaving them with the possibility of their lesion progressing to a precancerous lesion or advanced cancer.

On the other hand, the patients that we attend in our campaign receive the results of their papanicolaou, colposcopy and biopsy (in the cases that apply) four weeks after having attended, once they receive them, the Medical Coordinator of Social Impact communicates with those who presented alterations to explain their results and provide them with a date of care. Once they attend their treatment, each patient is called for follow-up as many times as necessary, until they are discharged. All this procedure has no cost to the patient.

With our innovation we ensure that patients receive their results, know their health status and their solutions, we have the information that allows us to ensure that all patients receive the treatment they need and that we make the necessary decisions to act, for example, to know If the patient did not attend her biopsy or treatment, call her and find out the reasons, because the system allows us to have that control.

The long-term benefits are:

● Reduction in morbidity and mortality specially among marginalized women.

● Prevent HPV complications and detect precancerous injuries on time and avoid risk factors

● Promote a culture of prevention and screening among marginalized communities.

This will be achieve attending more women every year, for the next year we hope to have served more than 9,000 women, in 5 years almost 30,000 women completely free.

Work with more than 100 associations and have visited more than 50% of the municipalities in the State of Mexico, which has 125 municipalities. Implement free campaigns in each of the states of the country where we have a clinic, the 2027-2030 plan is to have 13 hospitals and 30 clinics throughout the country, this will allow us to cover more vulnerable territory throughout Mexico

From 2015 to date, the percentage of mortality from cervical cancer in the State of Mexico has been reduced by 1%. We are sure that both our clinics and the free campaigns that we have carried out throughout these 4 years have contributed to this reduction. Therefore, we expect that in 5 years this percentage (1%) will have increased.

Each quarter we prepare an impact report with the following indicators:

• Patients attended
• Services provided
• Treatments provided
• Workshops on prevention and gynecological care
• Workshop attendees
• Sociodemographic information
• NPS
• Baseline questionnaires and surveys
• Questionnaires and surveys to find out what knowledge patients acquire
• Questionnaires and surveys to find out what changes patients made to improve their gynecological care
• Questionnaires and surveys to find out how much the quality of life of our patients has changed

To ensure our impact, we use the theory of change as a methodology, we apply this ladder as a visual representation of our social intervention, in which the different components and the link between them are identified.

Our solution can be carried out since the IT area developed a colposcopy system that speaks with the colposcope used in the campaigns.

First, the patient is registered in this system, all her sociodemographic data are taken, when the colposcopy and papanicolaou are taken, the colposcopy photographs are recorded in the patient's profile and labels are prepared with all the data for the pathological samples (paps and biopsies) that will be delivered to the pathologist. The pathologist has a username and password that allows him to upload the results of each patient. Once this is done, the system sends a notification to the doctor so that he can validate it and as soon as he does, the patient will automatically receive his results via SMS or mail. In the same way, the system has a programming that allows the traffic light to be given to the patient according to the results that the pathologist has registered. This allows the system to automate a dashboard for us to know all those patients who come out green (healthy) yellow (low-grade lesion) red (high-grade lesion and cancer).

With this we give a timely follow-up to our patients and we know who we must make an appointment for biopsies and treatments, making sure that the largest possible number of patients come, locating those who do not attend to call them and find out the reasons why they did not attend.

We are a company that promotes respect and solidarity, we offer equal opportunities without discrimination, we recognize that diversity and inclusion enrich work teams.

More than 50% of our collaborators are women, 3% are from another Latin American country and more than 50% of the management team is made up of women.

Our philosophy is based on the values of professionalism, empathy, ethics, humility, camaraderie, joy.

We seek to provide an environment free of discrimination and exclusion; We have a code of ethics that allows us to prevent all types of discrimination and harassment

We are the only private and high quality gynecological attention model, affordable for socioeconomic levels lower than C+.

Reina Madre plays a unique role in Mexico’s health care scenario. We offer high quality gynecological care at low cost to a population sector that otherwise would be restricted to careless and inefficient services. Now we are pushing ourselves to expand the accessibility to medical attention for Mexican women.

Reina Madre seeks to offer comprehensive care to women at all stages of their lives, their main specialties being Gynecology and Pediatrics. Initially, Reina Madre focused on deliveries and caesarean sections, managing to reach 870 births during 2016, 1,368 during 2017 and 1,780 during 2018 and we closed 2022 with 4,559 births, becoming the #1 private hospital in gynecology and maternity in Toluca.

This project has been financed through donations, grants, alliances, recovery fees, as well as the offer of graduate courses for doctors who manage to cover the costs of supplies and logistics

In 2019 we carried out the project 100% financed by us, we treated 250 women and diagnosed 72 injuries, the impact was so strong that we decided to put it in calls with foundations to be able to scale it and replicate it in more states. In 2021 we were selected by two foundations and with that donation we managed to serve more than 1,500 women and implement it in two different places, in the state of Mexico and in Mexico City, although we continue to finance a part but in 2022, we managed to make it sustainable with a project of education for doctors, enrollment in the course allowed to achieve 4 campaigns with a duration of 6 months each, serving more than 3,000 women.