Maseko Fresier Chidyaonga, Chirwa Maureen Leah, Muula Adamson Sinjani
School of Public Health and Family Medicine, Department of Community Health, University of Malawi, College of Medicine, Mahatma Gandhi Road, Private Bag 360, Chichiri, Blantyre 3, Malawi.
Prime Health Consulting and Services, Prime Health Consulting and Services A47/5/240, Malingunde Road, Lilongwe, Malawi.
Pan Afr Med J. 2015 Nov 17;22:247. doi: 10.11604/pamj.2015.22.247.6439. eCollection 2015.
Malawi has the highest incidents of cervical cancer followed by Mozambique and Comoros thus according to the 2014 Africa cervical cancer multi indicator incidence and mortality score card. Despite having an established cervical cancer prevention program, there is low screening coverage. Studies have been carried out to determine socio-cultural and economical barriers to cervical cancer prevention services utilization and very few have concentrated on health system and policy related barriers to cervical cancer prevention and control. The paper presents finding on a qualitative study which carried out to determine the suitability of the national sexual and reproductive health and rights [SRHR] in mitigating challenges in cervical cancer control and prevention.
a desk review of the Malawi National Sexual and Reproductive Health and Rights [SRHR] policy 2009 was done with an aim of understanding its context, goal and objectives. Analysis of the policy history provided insight into the conditions that led to the policy. Policies from countries within the region were referred in the review. Government officials were interviewed to solicit information on the policy.
Malawi does not have a standalone policy on cervical cancer; however, cervical cancer is covered under reproductive cancer theme in the SRHR. Unlike some policies within the region, the Malawian SRHR policy does not mention the age at which the women should be screened, the frequency and who is to do the screening. The policy does not stipulate policy implications on the ministry of health, the SRH programs and health service providers on cervical cancer. Furthermore the policy does not include HPV vaccination as a key component of cervical cancer control and prevention.
the policy does not reflect fairly the best attempt to reduce the incidence and mortality of cervical cancer as such we recommend that the Reproductive Health Directorate to consider developing a standalone policy on cervical cancer control and prevention.
根据2014年非洲宫颈癌多指标发病率和死亡率记分卡，马拉维的宫颈癌发病率最高，其次是莫桑比克和科摩罗。尽管已经建立了宫颈癌预防计划，但筛查覆盖率较低。已经开展了研究以确定宫颈癌预防服务利用的社会文化和经济障碍，很少有研究关注与宫颈癌预防和控制相关的卫生系统和政策障碍。本文介绍了一项定性研究的结果，该研究旨在确定国家性与生殖健康及权利政策在缓解宫颈癌控制和预防挑战方面的适用性。
对2009年马拉维国家性与生殖健康及权利政策进行了案头审查，目的是了解其背景、目标和宗旨。对政策历史的分析提供了导致该政策出台的条件的见解。审查中参考了该地区其他国家的政策。采访了政府官员以获取有关该政策的信息。
马拉维没有关于宫颈癌的独立政策；然而，宫颈癌在性与生殖健康政策中的生殖癌症主题下有所涵盖。与该地区的一些政策不同，马拉维的性与生殖健康政策没有提及女性应该接受筛查的年龄、筛查频率以及由谁来进行筛查。该政策没有规定对卫生部、性与生殖健康计划以及卫生服务提供者在宫颈癌方面的政策影响。此外，该政策没有将人乳头瘤病毒疫苗接种作为宫颈癌控制和预防的关键组成部分。
该政策没有公平地反映出为降低宫颈癌发病率和死亡率所做的最佳努力，因此我们建议生殖健康局考虑制定一项关于宫颈癌控制和预防的独立政策。
