Identifying the barriers and facilitators to cervical cancer prevention and control in Malawi: A qualitative approach

In Malawi at least 31 out of every 100,000 women develop cervical cancer and approximately 80% of them will die from this malignancy. Malawian women have limited access to resources for prevention of cervical cancer; therefore, HPV vaccination may provide a vital strategy for primary prevention for many Malawian women. Important questions and concerns regarding cervical cancer and vaccination acceptance among individuals and their community must be considered prior to vaccine initiation.

The World Health Organization's guidelines for knowledge, attitudes, and practice surveys were used to guide in-depth, semi-structured interviews with 30 Malawian women (Mean age=32 years). One-hour interviews were conducted in Chichewa and translated into English. Women's knowledge and beliefs about cervical cancer and prevention, as well as health behaviors that women engage in were explored. Phenomenology was used to elucidate potential barriers/facilitators to widespread implementation and acceptance of HPV vaccination, as well as to uncover vital information regarding current cervical cancer prevention techniques in Malawi.

Low knowledge about cervical cancer and perceived risk, distance to hospitals and lack of medical resources were identified as barriers to cervical cancer prevention. Facilitators included trust in medical professionals, perception that cervical cancer was serious, and positive experiences with vaccines. Cervical cancer prevention measures in Malawi may improve by educating women about the etiology of cervical cancer, the importance of early detection, and risk. All of the women reported that they wanted their children to get the HPV vaccine and supported the development of an HPV vaccination program in Malawi.