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Group 2: Lesotho, Malawi, and Zambia
Group 2 found a number of common concerns in their countries:
• Inadequate (or misallocated) human resources.
• Limited awareness of cervical cancer among key stakeholders (including communities and health
workers).
• Competing health needs leading to low prioritization of cervical cancer control for funding.
• Absence of cervical cancer control policy.
Behind most problems was a lack of funding. Participants noted several specific difficulties in budgeting:
• In some cases the MOH funds go directly to hospitals (at the district level, for example). Thus,
the hospital directors or boards must include cervical cancer prevention in their budget
requests, and advocates must work to get these provisions into the hospital budgets.
• Some countries have a family planning budget, but no reproductive health budget, so it is
important to know how to fit cervical cancer prevention into the existing structure.
• Unless there is a national policy on cervical cancer, it is difficult to lobby for funding.
Implementers on the ground cannot fit their needs into the list on the official budget unless
cervical cancer prevention is a priority and has a budget line.
• In many instances, human resources are available, but they are not doing the right things; thus,
it is a matter of misallocation of funding.
Other discussion points included how to present technical points to policymakers, coordination of donor
programs, and the need for one leader to coordinate cervical cancer prevention efforts in a country.
• Policymakers may be confused when they hear requests for different technologies for cervical
cancer prevention (i.e., vaccine, DNA tests, and VIA). Advocates need to know their science and
to package it in an understandable way for lawmakers.
• Sometimes outside programs bring help to countries, but nothing is sustainable without
government commitment and funding. Further, there is a need to coordinate these outside
programs.
• Strong opinions were voiced on the need to identify one person from the programs involved in
cervical cancer prevention—immunization, cancer, and reproductive health—to take charge of
the country agenda and move it forward.
Listed below are some “wish list” priorities from the discussions.
Lesotho
• Establish a cancer registry.
• Develop guidelines and indicators for monitoring and evaluation as well as impact analysis.
• Advocacy, generate new interest, instill new energy.
Report of an African Regional Meeting on Cervical Cancer: September 2010 52