146740 Bringing services where they are most needed: Cervical cancer prevention and treatment in Malawi

Tuesday, November 6, 2007: 2:50 PM

Amy Kleine, MPH, MSW , Cervical Cancer Prevention Program, JHPIEGO Corporation, Baltimore, MD
Godfrey Nkhoma, BSc , JHPIEGO Malawi, Lilongwe, Malawi
Marya Plotkin, MPH , Family Planning and Reproductive Health Center of Excellence, JHPIEGO Corporation, Baltimore, MD
Watson Moyonsana, Dip IT , JHPIEGO Malawi, Lilongwe, Malawi
Abigail Kyei, MPH , JHPIEGO Malawi, Lilongwe, 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


% (of total women screened)













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.  

Learning Objectives:
At the conclusion of this session, participants will be able to: Describe results achieved by the national cervical cancer prevention program in Malawi Discuss the successes and challenges of introducing cervical cancer prevention and treatment services into low-resource settings. Share ideas for starting or expanding cervical cancer prevention and treatment in low-resource settings.

Keywords: Cervical Cancer, Developing Countries

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.