a Department of Global Health and Development , London School of Hygiene and Tropical Medicine , London , UK.
Glob Public Health. 2013;8(10):1093-108. doi: 10.1080/17441692.2013.850524. Epub 2013 Nov 18.
Cervical cancer is the second leading cause of cancer deaths for women globally, with an estimated 88% of deaths occurring in the developing world. Available technologies have dramatically reduced mortality in high-income settings, yet cervical cancer receives considerably little attention on the global health policy landscape. The authors applied four policy-analysis frameworks to literature on global cervical cancer to explore the question of why cervical cancer may not be receiving the international attention it may otherwise warrant. Each framework explores the process of agenda setting and discerns factors that either facilitate or hinder policy change in cases where there is both a clear problem and a potential effective solution. In combination, these frameworks highlight a number of crucial elements that may be needed to raise the profile of cervical cancer on global health agendas, including improving local (national or sub-national) information on the condition; increasing mobilisation of affected civil society groups; framing cervical cancer debates in ways that build upon its classification as a non-communicable disease (NCD) and an issue of women's rights; linking cervical cancer screening to well-funded services such as those for HIV treatment in some countries; and identifying key global policy windows of opportunity to promote the cervical cancer agenda, including emerging NCD global health discussions and post-2015 reviews of the Millennium Development Goals.
宫颈癌是全球女性癌症死亡的第二大主要原因,据估计,发展中国家 88%的死亡病例由此导致。现有的技术已大大降低了高收入国家的死亡率,但宫颈癌在全球卫生政策领域几乎没有得到太多关注。作者将四个政策分析框架应用于全球宫颈癌文献,以探讨为什么宫颈癌可能没有得到它可能需要的国际关注。每个框架都探讨了议程设置的过程,并辨别了在存在明确问题和潜在有效解决方案的情况下,促进或阻碍政策变革的因素。这些框架结合起来,突出了一些可能需要的关键要素,以便在全球卫生议程中提高宫颈癌的地位,包括改善有关该疾病的当地(国家或国家以下一级)信息;增强受影响民间社会团体的动员;以将宫颈癌辩论建立在其被归类为非传染性疾病(NCD)和妇女权利问题的基础上;将宫颈癌筛查与资金充足的服务联系起来,如一些国家的艾滋病毒治疗服务;以及确定促进宫颈癌议程的关键全球政策机会窗口,包括新兴的非传染性疾病全球卫生讨论和 2015 年后千年发展目标审查。