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Introduction: Sub-Saharan Africa is experiencing a rapid epidemiological transition with the increasing incidence of Non-Communicable Diseases (NCD). Among these, cancer is one of the main causes of death in adults. This is a public health problem whose burden is unknown due to lack of statistical data. In addition, the already overburdened health systems are experiencing enormous constraints to address the problem with the double challenge of communicable and NCDs., Methods: The purpose of this evaluation was to assess the capacity and needs of health systems to prevent and control cancer. A cross-sectional study, using both quantitative and qualitative methods, was conducted between April 2017 and February 2018 in target countries, through in-depth interviews with key actors, direct observations and documents review. The WHO framework for health system strengthening with the 6 pillars was used for the gaps analysis., Results: Little priority is given to the fight against cancer because of low political commitment. Programs´ resources are very limited and there is a poor coordination of the actions. Human resources are insufficient, and most of them are concentrated in the capital city. This limits access to care with a late consultation of patients. Diagnosis and treatment services are expensive and generally paid by households. Finally, the unavailability of reliable data at national level hinders the decision-based evidence., Conclusion: There is an urgent need to create strong partnerships at national and regional levels to (i) Advocate for a strong political commitment; (ii) Strengthen the coordination of actions and create more synergy among stakeholders; (iii) Improve the quality and quantity of human resources; (iv) Extend universal health coverage to cancer and improve program funding; and (v) Set up cancer registries at national level., Competing Interests: The authors declare no competing interests., (© Omobolaji Ayandipo et al.)

The monitoring and evaluation is usually the weakest component of health programs in sub-Saharan Africa, what is undermining the sustainability of funding. The problems are complex and the weaknesses of the health systems are reflected on the monitoring and evaluation of specific programs. This paper gives an insight of the problems faced during field missions for monitoring and evaluation. The steps for building the M&E system have been reviewed and keys points for implementation have been provided.

The Institute for Health and Development (ISED) at the University of Dakar, was created in 1987. Its mission is to fulfill the public health training needs of Senegalese health care professionals. ISED is responsible for a training program entitled "Certificat d'études Spéciales" (CES), the equivalent of a Masters of Public Health degree. The "CES" is a two-year program comprised of six modules, which last four months each. The ISED training approach stresses trainee responsibility above all. It is based on the trainee's professional tasks and is oriented toward the problems identified by the trainees themselves. In this sense it is highly adaptive and flexible. Each module is implemented in the same way; initially there is a 15 day residential phase for intensive theoretical courses, followed by an application period of 75 days in the trainee's work place, and then a final residential phase of 15 days for writing and presenting a technical report on the work in the field. This model allows trainees to bring together the theoretical and the practical. The trainers directly supervise each of these three phases. The two residential phases are conducted in the ISED training center, located in Mbour, 80 Km south of Dakar. 103 trainees are enrolled in the program in seven different classes. Of these trainees, 93 are health care specialists (85 physicians 7 pharmacists, 1 dentist). Ninety percent of previous graduates have been civil servants who work for the Ministry of Health in Senegal and the remaining 10% were from Burkina Faso and Togo. The training program is considered by all stockholders, beneficiaries, and relevant financial institutions, to be appropriate, beneficial and successful.