Policy Report: Introducing an Effective National Cancer Control Plan in the Maldives

Abstract

Background and context: There is no National Cancer Control Plan (NCCP) in the Maldives. The Health Plan has identified cancer as an area with a need for development of separate policy, strategy paper while it is also reflected in the Multi-Stakeholder Action Plan for NCDs. Aim: The main aim of the project is to produce a policy report to guide the development of an effective National Cancer Control Plan (NCCP) in the Maldives. The objectives are to estimate the total period prevalence of cancer in the Maldives (2013-2014); to understand the views of key stakeholders; and synthesize this to develop a policy report and applying the “Cancer Control, Knowledge into Action: WHO Guide for Effective Programmes - in Low and Middle Income Countries”, to the Maldives context to identify priority components in light of the prevalence estimates and views of the key stakeholders. Strategy/Tactics: The policy report will bring together the findings from secondary analysis of quantitative data, analysis of key informant in-depth interviews from stakeholders, using the framework analysis method for qualitative data analysis and applying the “WHO Guide for Effective Programmes - in Low and Middle Income Countries”, to the Maldives context and identify priority components in light of the prevalence estimates and views of the key stakeholders. Outcomes: Among a population of 344,023 people, the estimated total period prevalence for all cancers in the period of 2013-2014 in Maldives is 0.92% (920 cases per 100,000 population). The estimated prevalence is 0.84% for males and 1.01% for females. Oral cancers (including lip, tongue, gum, mouth, and palate) is the most common cancer, followed by eye, breast (with carcinoma in situ), sinuses, skin (melanoma and skin cancers and carcinoma in situ). How common eye cancers and sinus cancers could be reflected as an anomaly in the data as these are uncommon when regional prevalences are compared or is an area where further research is warranted. Thyroid, prostate, lymphomas, leukemias and lung cancers are among the top 10 cancers. The key informant interviews, revealed that there are very limited services available for cancer prevention, diagnosis, treatment and care. What was learned: It is evident that there is a substantial amount of work to be done with regard to cancer control in the Maldives. The high prevalence of cancer and the views of the respondents from the study emphasizes the need for developing a National Cancer Control Plan (NCCP) as an initial step toward comprehensive cancer control efforts in the Maldives. A comprehensive cancer prevention strategy with early detection-early diagnosis and screening should be a priority component for the NCCP, with improvement of diagnosis and treatment services and establishment of a comprehensive palliative and psychosocial care program across the cancer care continuum. This policy report will provide guidance to development of an NCCP with priorities identified.