One Step Closer to Ending Cervical Cancer

Malawi has the second-highest rate of cervical cancer in the world. The small African country has initiated strategies to keep women from dying from cervical cancer, and, in addition to increasing active cancer screening and treatment services, the Malawi Ministries of Health and Education worked with several partners to introduce human papilloma virus (HPV) vaccination in 2019. 

Human papillomavirus is a widespread viral infection that has serious consequences, including cervical cancer. The vaccination effort uses a school health platform to reach 9-year-old girls with two doses of HPV vaccine in line with WHO Cervical Cancer Prevention Guidance.

Hannah Hausi, a JSI senior immunization advisor, is working with the Government of Malawi to ensure smooth introduction throughout the country. When the HPV vaccine was first introduced in 2019, it was a challenge to determine the number of eligible girls because birth registration is not a uniform practice across the country. And because the number of eligible girls was uncertain, it was difficult to budget for and procure appropriate amounts of vaccines and associated supplies. JSI, working with other partners, gave teachers tools and processes to ascertain and document girls’ actual age. While the training helped, as did scheduling information-gathering at community events, getting accurate data on eligible girls remained a challenge.

So Hannah designed a mapping verification tool that sampled numbers of registered girls and followed up with parents to verify their ages. The JSI team found that only 55% of 9 year olds had been correctly recorded. The simple triangulation methodology led to a recommendation to include verification as part of subsequent exercises to ensure that all eligible girls are registered. The government has continued to use this mapping verification tool to adjust the data, leading to greater accuracy in estimating the number of eligible girls and corresponding amounts of vaccine and other materials. 

Many public health challenges can be overcome using practical and simple solutions on the frontline, like those that Hannah and the JSI team implemented. These efforts are helping Malawi to move one step closer to preventing cervical cancer.

Written by Folake Olayinka