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e used for advocacy and communication. The recent conference in Accra (4 th Stop Cervical Cancer in
Africa Conference) is an example of increasing awareness and fostering dialogue.
The Ugandan experience with vaccination and new screening technologies has given other African
countries a “window of hope” in looking toward the future.
Cervical Cancer Prevention in Lesotho
Mrs. Florence Mohai
Head, Family Health Division
Ministry of Health and Social Welfare, Lesotho
Mrs. Florence Mohai reported that in 2006 the Ministry of Health and Social Welfare (MOHSW) of
Lesotho conducted a review to determine the magnitude of cervical cancer incidence in the country. The
age standardized incidence rate was found to be 66.7 per 100,000 women. Guidelines on screening
were developed in 2007 and training was conducted for health professionals in four of the ten districts
in the country in 2008.
Communities must be informed
and educated about cervical
cancer and HPV vaccines in order
to dispel misconceptions.
In 2008, the MOHSW in collaboration with Lesotho-Boston
Health Alliance received a donation of more than 120,000
doses of Gardasil® to target approximately 40,000 nine- to
eighteen-year-old females in two districts, using schools as
the venue. To prepare for the pilot vaccination programs,
nurses were oriented; IEC materials were developed; and
sensitization workshops were conducted for decisionmakers,
parliamentarians, parents, school teachers, and children. The MOHSW received support from
United Nations (UN) agencies and from partners during the vaccination sessions; the sessions were
integrated into the routine EPI program without any change to the cold chain. Because of a successful
application for more vaccine, vaccinations will continue in 2011 in the same districts.
In the first round of vaccinations, the coverage was 90.5 percent, in the second, 85.6 percent, and in the
third, 84.5 percent. Challenges for introducing HPV vaccine on a large scale include the cost of the
vaccine and associated program costs. In the pilot projects, girls missed second or third doses because of
inclement weather, school examinations, or pregnancy, and some families avoided vaccinations because
of rumors spread by email.
While the pilot vaccinations were successful, there is need for human resources and infrastructure
support for scale-up. Other government agencies, in addition to the MOHSW, must support cervical
cancer prevention. Communities must be informed and educated about cervical cancer and HPV
vaccines, in order to dispel misconceptions.
For screening, Pap smears have been available and recently VIA was introduced. Lesions are treated
with cold conization, but no information is available on cryotherapy. Women who are diagnosed with
invasive cervical cancer are referred to the Republic of South Africa, where those with advanced cases
Report of an African Regional Meeting on Cervical Cancer: September 2010 30