African cervical cancer prevention and control plans: A scoping review

Africa has a disproportionate burden of cervical cancer. As a part of the strategic approaches to contain the disease, several African countries have developed cervical cancer prevention and control (CCPC) plans. Such plans can help to create policy and program enabling environments to reduce cervical cancer. To date, there has not been any review of these plans. Method: A scoping-review was conducted of African country-level plans available online between June-October 2016 to describe the existence and focus of cervical cancer planning using adapted measures from the Healthy Public Policy Model. Results: Less than one quarter of countries (22.2%, n = 12) had plans available for analysis. Of these plans, 69.2% had expired. The majority of countries with any stated plan for cervical cancer had CCPC elements embedded in other disease-focused plans. Five plans framed cervical cancer as cancer, and rest as the outcome of human papillomavirus (HPV), which is sexually transmitted. All plans emphasized survivorship more than early HPV diagnosis and prevention. Planned interventions targeted only women and girls. Rudimentary monitoring and evaluation (M&E) systems, and lack of integration of cervical cancer M&E with national health management information systems and cancer registries were shared issues. Plans reflected a top-down framing of community as beneficiary rather than an equal partner to technical experts in plan formulation and evaluation. Conclusion: A comprehensive picture of African CCPC efforts will require engagement with Ministry of Health (MoH) in each country. Extant evidence suggests that lack of resources is a major barriers to plan development and deployment.