Bringing services where they are most needed: Cervical cancer prevention and treatment in Malawi

  Background: Cervical cancer is accounts for approximately 30% of all female cancers in Malawi. As in many developing countries, Malawi had no national cervical cancer control program until 2004, when the Ministry of Health (MoH) together with JHPIEGO launched a program to screen for and treat cervical pre-cancer using visual inspection with acetic acid (VIA) and cryotherapy. Methods: Since November 2004, 67 providers were trained, 13 local trainers were developed, and 11 technicians were trained to repair cryotherapy units. Advocacy and community awareness campaigns were conducted to increase program visibility. Results: As of December 2006, 22 health facilities were providing VIA and cryotherapy services, and the following results have been achieved:

 

Women Screened for pre-cancerous lesions	Women found positive for precancerous lesions		Women treated with immediate cryotherapy	Women referred for large lesions
	N	% (of total women screened)
7,068	768	10%	415	169

 

 

 

 

 

 

 

Discussion: The cervical cancer prevention program in Malawi is a pioneer program attempting to introduce cervical cancer screening and treatment into public health services in Africa. Successes have included: strong commitment by the MoH; excellent uptake of skills by Malawian health service providers; client acceptance and interest ; and local level funding for and integration of cervical cancer services into facilities. The challenges include limited resources for community education efforts; shortage of staff in service provision sites; and insufficient funds to scale up. This session will present successes and challenges with the aim of encouraging other low-resource countries to address this important women's health issue.