Public-Government Partnership to Improve Breast Cancer Outcomes for Low-Income Populations in Salvador, Bahia – Brazil

Since the 1980s, Brazil has developed targeted policies and programs in response to increasing breast cancer incidence and mortality. Today, breast cancer is the leading cause of death from cancer in Brazilian women, and a growing concern among the Afro-Brazilian population affected by longer intervals between diagnosis and initiation of treatment, and mortality rates at 41%. Salvador, Brazil’s third largest city has a population of 2.9 million inhabitants, 80% of Afro-Brazilian descent and ~20% living in extreme poverty. The Afro-Brazilian population is generally characterized as poorer and with higher rates of illiteracy. 

This initiative builds upon the notion that the municipal government has an important role in promoting health education to reduce disparities and should share this responsibility with federal and state governments. This unique collaboration between FIEMA (Municipal Fund for Human Development and Inclusion of Women of African Descent), an organ of the Salvador Municipal Secretary of Education; Susan G. Komen®, a US nonprofit organization; and Visconde de Cairu Foundation, a Brazilian educational institution, prepared college-level students in the Social Service, Psychology and Social Work track to serve as multipliers delivering educational sessions in secondary schools within the Salvador municipality. 

The three-day twelve-hour course followed the ‘train-the-trainer’ methodology and was based on Komen’s Breast Self-Awareness approach including four key messages: 1.Know your risk, 2.Get Screened, 3.Know what’s normal for you, 4.Make healthy lifestyle choices. Thirty participants received certificates of completion and within three months delivered 16 lectures on Breast Self-Awareness in 13 different middle and low-income communities impacting 500 community members including students, parents and school staff.

Effective leveraging of resources led to minimal financial investment from partners and resulted in a sustainable education model. Long-term, this example of collaborative governance may serve as a replicable model for improved breast health outcomes among low-income populations in Brazil.