Cervical Cancer Prevention and Control in Nigeria: Mapping and review of policies.

Abstract

Cervical cancer is a significant public health issue in Nigeria and a major cause of cancer-related morbidity and mortality among women. Equitable implementation of cervical cancer control programs alongside relevant policies and strategic plans is vital to reducing the burden of cervical cancer and improving quality of life. Considering the role of policies in guiding program implementation, we reviewed Nigeria's cervical cancer policy landscape to identify strengths, limitations, and opportunities for improvement. This policy appraisal involved a literature review to understand related policy review frameworks, developing a modified framework containing six domains, systematically searching key databases and websites to identify relevant policy documents, data extraction and analysis, and synthesizing findings from reviewed documents. A total of five documents were reviewed in this study - three integrated cancer control plans, a cervical cancer policy, and a strategic plan for cervical cancer prevention and control. Two of the reviewed documents are current (2023-2027), one is outdated, and two are expired. Key strengths identified in these documents include i) a clear articulation of goals, ii) a collaborative development process, iii) the adoption of a phased implementation approach for proposed interventions, iv) detailed intervention plans, and v) monitoring and evaluation plans with performance indicators. In contrast, key limitations include i) poor participation of subnational level stakeholders, ii) absence of costing and funding approach in some plans, iii) lack of baseline data on unmet needs and outcomes of previous plans, and iv) absence of health system resource mapping. Addressing identified limitations is critical to improving the quality of policy and policy-informing documents, strengthening implementation across all levels, lowering the cervical cancer burden, and improving women's health outcomes.