Abstract
Policy mapping is used to provide evidence on effective interventions and highlight the necessary refinements of health policies. The goal of this work is to carry out legal mapping to identify and assess health policies for the prevention and management of cervical cancer in East African countries. Cervical cancer, as a largely preventable disease, is the cause of most cancer deaths among women in East African countries. Legal documents were searched uniformly from government websites, national cancer institute sites, and international and national legal databases, then the data were analyzed using the Nvivo12 software package. The sample of 24 documents includes policies, plans, guidelines, acts, and strategies from 12 East African countries. The emerging themes were screening, prevention, diagnosis, treatment, challenges, and mitigation efforts. A few binding policies, a significant discrepancy to international standards in at least four countries, patchy screening registries, and a lack of prophylactic vaccination against human papillomavirus incorporation into national immunization schedules are the main findings. This paper underlies the role of law in health and the need for transparent legal and regulatory tools to achieve a further reduction in cervical cancer mortality in East African countries.
Highlights
From the total number of cancer deaths among women in Sub-Saharan Africa (SSA), 19.3% are attributed to cervical cancer [2]
Cervical cancer screening is recommended for women to detect precancerous changes in the cervix [26]
The World Health Organization (WHO) Comprehensive cervical cancer control guide to essential practice recommends these practices for the screening and treatment of precancerous cases, due to the evidence of their capacity to reduce the incidence of cervical cancer [7,63]
Summary
Burden of Cervical Cancer in East African Countries. In 2018, cervical cancer was the fourth most common cancer worldwide in women, contributing to. 6.9% of the total number of new cases [1]. Among the 20 countries with the highest incidence of cervical cancer, 16 are African countries. From the total number of cancer deaths among women in Sub-Saharan Africa (SSA), 19.3% are attributed to cervical cancer [2]. Cancer Observatory data for East Africa, cervical cancer had the highest incidence among women, with 52,633 new cases and 37,017 deaths [3]. Cancer of the cervix is mainly attributed to human papillomavirus (HPV) types 16 and 18.
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