title: Cervical cancer control and prevention in Malawi: need for policy improvement.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: Fresier Chidyaonga
authors.initials: FC
authors.lastname: Maseko
authors.affiliation: Prime Health Consulting and Services, Prime Health Consulting and Services A47/5/240, Malingunde Road, Lilongwe, Malawi.
authors.forename: Maureen Leah
authors.initials: ML
authors.lastname: Chirwa
authors.affiliation: 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.
authors.forename: Adamson Sinjani
authors.initials: AS
authors.lastname: Muula
mesh_terms: D005260:Female; D006291:Health Policy; D006801:Humans; D015994:Incidence; D008295:Malawi / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods*; D030361:Papillomavirus Infections / Q000150:complications / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D060728:Reproductive Health; D046269:Reproductive Rights; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D053918:Papillomavirus Vaccines
keywords: Cervical cancer; cervical cancer control and prevention; policy