A Review of Cervical Cancer Prevention Policies in Kenya and Malawi
Corrina Moucheraud, Lynette Kamau, Moreen Nkonge, Erick MugePURPOSE
Cervical cancer is a major public health concern, and one of the leading causes of cancer-related mortality among women in Kenya and Malawi, yet the coverage of the HPV vaccine and cervical cancer screening remains below WHO targets. This study reviewed national policies in the two countries to identify key actors, contextual factors, and policy processes informing cervical cancer prevention and recommends policy-focused strategies to improve coverage of prevention services.
METHODS
We analyzed 12 national documents from Kenya and 5 from Malawi, all government-issued and applicable from 2018 onward (or earlier if no updates were available). The Walt and Gilson Policy Triangle Framework guided the review.
RESULTS
In both cases, cervical cancer prevention through vaccination was addressed within broader policies on cancer and reproductive health. Among policies reviewed, 8 of 12 in Kenya and 2 of 5 in Malawi were outdated or had unclear operational status. Weak implementation and monitoring and evaluation guidance for HPV vaccination were also observed. In Kenya, few documents outline specific interventions to improve vaccination coverage, while Malawi falls short in integrating vaccination into existing health programs. Across the board, M&E frameworks on vaccination targets or indicators were inconsistently defined. The review also revealed limited expert input and youth involvement in the development of existing policies.
CONCLUSION
Cervical cancer prevention strategies require up-to-date health policies co-designed with expert and youth input to ensure relevance. Explicit guidance on implementation and robust monitoring and evaluation frameworks are key to operationalizing these policies and achieving the goal of cervical cancer elimination.