The C/Can City Engagement Process

Take a look below to discover our process for supporting cities over a two-year period. All stakeholders work together to identify, plan and then implement solutions to close the gaps in quality cancer care — from diagnosis, through to treatment, palliative and supportive care. In short, our purpose is to improve access to quality and equitable cancer care in our cities.

The C/Can model provides local leaders with the tools they need to drive this process from the ground up. What does this really mean within a city? Here are some highlights from the City Engagement Process currently underway in the Brazilian city of Porto Alegre.

The C/Can model

Stakeholder Engagement

• Porto Alegre joined the initiative in September 2018 when it signed a Memorandum of Understanding (MoU) with the City of Porto Alegre, State of Rio Grande do Sul and Femama – Federação Brasileira de Instituições Filantrópicas de Apoio à Saúde da Mama, that provides a framework for cooperation.
• Porto Alegre completed its mapping of key cancer care stakeholders in February 2019, with the identification and convening of 15 local institutions, across relevant sectors, forming the City Executive Committee, the body responsible for driving the initiative forward, guiding, overseeing and approving decisions and milestones in the City Engagement process.

Needs Assessment

• Between March and May 2019, guided by local insights and technical expertise, the City Executive Committee oversaw a comprehensive, city-wide, data-driven needs assessment. This was implemented by a multidisciplinary Technical Committee made up of 17 members tasked with identifying cancer care gaps and proposing solutions. To garner in-depth information on the current state of delivery of cancer treatment and care services in a city, C/Can used a single online assessment questionnaire. By analysing responses to the questionnaire, specialists from the main institutions in the city provided the data underpinning the cancer care situation analysis.  In total, 168 professionals from 33 institutions, along with 98 patients, all participated in our needs assessment process in Porto Alegre!

“The idea is to work together to identify problems and come up with solutions that change reality and provide better quality assistance for cancer patients. We have finished the diagnostic phase, and with C/Can we’re bringing together the excellence of municipal oncology services to define strategies in the fight against the disease”

Pablo Stürmer
Municipal health leader
C/Can Executive Committee

• Now we need to prioritize the main challenges: on May 27 and 28, the Technical Committee members presented and discussed the results of the assessment and analysis carried out by each group to identify and agree on the main challenges in accessing quality and equitable cancer care in the city. In total 88 challenges were presented and 33 prioritized. The 33 challenges and priority actions proposed by the Technical Committee were presented in the second Executive Committee meeting, held on May 29.

Action Planning

• This phase entails converting the 33 challenges identified in the Needs Assessment Phase into a detailed road map.
• The main output of the Action Planning Phase is the City Activity Plan: a matrix of strategic objectives and priority actions, with local coordinators committing to the lead in executing each objective. w. City Stakeholders worked from June to August in this phase to structure the Porto Alegre City Activity Plan, which is composed of 13 high-level objectives, each with a number of priority actions. The Activity Plan was approved by the Executive Committee on August 30, 2019.

“We are looking to improve our hospital and population cancer registries. With data closer to reality, we can plan better public and private policies for coping with the disease.”
Rafael Vargas”
Oncologist at Santa Casa de Porto Alegre
C/Can Executive Committee

Next steps

• In order to support the implementation of the objectives outlined in the Porto Alegre Activity Plan, the city will convene a technical working group, including relevant stakeholders, to agree on a simple high-level work plan for each objective. The aim of those meetings is to develop buy-in, agree on concrete actions, ensure that the proposed work plans are achievable, and maintain the momentum of plans to deliver specific outputs. After October, C/Can will support Porto Alegre to prepare the project plans. Project plans set out the activities and work plan required to deliver the overall objective and are clear on the specific deliverables for the project, proposed activities, timelines, budget and roles and responsibilities.

“The bottlenecks and lack of data sharing among different health services where patients are treated, waste time, human and material resources. The scenario we are building together is the opposite of this.”
Marcelo Capra
Oncologist Grupo Hospitalar Conceição
C/Can Executive Committee.