Analysis of cervical cancer policy documents in East-African countries

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Abstract Background Cervical cancer is largely a preventable disease according to data by Global Burden of Disease. Among the 20 countries with the highest incidence of cervical cancer globally, 16 are African countries. Relevant cancer control interventions in most low-income countries are partially developed attributing to unavailability of statistics limiting understanding and approximation of the magnitude of the burden of cancer. In order to evaluate health policies for prevention and management for cervical cancer among East-African countries a legal mapping was carried out. Methods Legal mapping as a qualitative research method is used to determinate existing policies, collect and analyze the information, and ultimately measure the effect of these policies on health outcomes. Legislation was searched from government websites, national cancer institute sites, international and national legal databases in a uniform way. Nvivo 12 software for content analysis of unstructured qualitative data related information was used for analysis. Coding of the data was developed by two researchers. Reliability of policies assessed according to Cohen's Kappa inter-rater reliability. Results The sample included 24 policies, plans guidelines, acts and strategic documents from 10 East-African countries. No relevant legislation identified from Somali and Djibouti. Majority of the countries had policy documents related to cervical cancer and touched on the components of cancer control. Majority of the East-African countries have not established screening registries leading to poor or no reliable data for assessing the cancer burden. Prophylactic vaccination against HPV is yet to be included in the national immunization schedules. Conclusions Findings show limited coverage of the identified policies, discrepancy to international guides. To reduce the harmful impact of the discordance between scientific evidence and policies, surveillance systems have to be set up/strengthened. Key messages Legislation which is brought into force to prevent cervical cancer is a pillar of effective public health efforts. Evidence based policy mapping plays a key role in giving insight on the burden of disease thereby making informed decisions for health.