About cervical cancer in Uganda
The crude incidence rate of cervical cancer in Uganda is estimated at 30 per 100 000, while the mortality rate was estimated at 19.9 per 100 000. The age-standardized incidence rate is 56.2 per 100000, while the age-standardized mortality rate is 41.4 per 100 000. According to these estimates, cervical cancer has simultaneously the highest incidence and mortality rate of all cancers in the country. The HPV Information Centre provides a crude incidence rate estimate of 28.8 for 2018. A 2011 review reported a number of estimates of high-risk HPV prevalence from 20 studies, ranging from 10.2% to 40% among HIV negative women and ranging from 37% to 100% among HIV positive women. The HPV prevalence estimates among women with normal cytology included in the HPV Information Centre report range from as low as 15.2% in women aged 25-60 to as high as 73.2% in women aged 12-24. Most of the prevalence studies were conducted prior to the introduction of the HPV vaccination programs in Uganda; therefore, these estimates may not reflect the current situation.
The Ministry of Health is responsible for overseeing Uganda’s largely decentralized healthcare system. Uganda’s health facilities are classified into seven levels based on the services they provide and the catchment area they are intended to serve. The health facilities are designated as Health Centre level one (HC I) to Health Centre Level four (HC IV), General hospital, Regional Referral hospital and National Referral hospital. The Uganda Cancer Institute is an autonomous body that coordinates the management of cancer treatment and prevention in the country.
General health policy/strategy
The current strategic document of Uganda’s healthcare system is the Second National
Health Policy document, released in 2010. Prevention and early diagnosis are generally proclaimed as one of the focus areas of the policy. The Health Sector Development Plan 2015/16-2019/20 is another strategic document, outlining the medium-term development agenda for the country’s healthcare system. The document does not appear to include specific provisions related to cervical cancer screening.
There does not appear to be a dedicated cancer policy document at the governing level. The most relevant document in this regard is Uganda Cancer Institute’s Strategic Plan for 2015/16-2019/20, which includes some provisions and target indicators related to cervical cancer treatment and screening.
Cervical cancer policy/strategy
The Strategic Plan for Cervical Cancer Prevention and Control in Uganda 2010 2014
includes a number of proposals and recommendations on the implementation of cervical cancer screening in Uganda.
Cervical cancer screening policy/strategy
Screening is conducted opportunistically using VIA and is targeted for women aged 25-49 at
a 3-year interval for human immunodeficiency virus (HIV) negative women and every year
for HIV-positive women. Lack of resources and infrastructure deficiencies result in a very low uptake of screening.
HPV immunization policy/strategy
Following several pilot projects between 2008 and 2012, a country-wide HPV vaccination
program was launched in 2015. Uptake appeared to vary considerably between vaccine doses, with estimates of 80% coverage for the first vaccine dose from 2015 to 2017, while
the second dose coverage ranged from 22% in 2016 to 39% in 2017.
Consortium partners working in Uganda
Uganda Rural Development and Training Programme: URDT is an NGO that has implemented a cervical cancer project in Kagadi District since 2017 using the Tell, See and Treat methodology, which includes sensitizing community members on cervical cancer prevention and control measures. URDT collaborates with the Uganda Cancer Institute at the national level and the health department in Kagadi District to implement, monitor and report about the progress of the project. URDT will oversee the implementation of the project in local communities, including the dissemination of information, communication with stakeholders, data management, coordination, screening and treatment of precancerous lesions, follow-up and reporting. The URDT cervical cancer team works closely with the URDT community-based staff, community leaders, Village Health Teams (VHT) to mobilise community members to participate in program activities
Uganda Cancer Institute: UCI is a government entity with autonomy to prevent, control and coordinate cancer related activities, as well as cancer research, in Uganda. UCI is involved in support, supervision and monitoring of an on-going project by Clinton Health Access Initiative looking at acceptability and operational feasibility of HPV testing in HIV positive women as a primary cervical cancer screening method. It is also involved in another ongoing project of integrating HPV testing into HIV care in 604 health care facilities across the country. UCI will lead the implementation of the project in Uganda. The UCI laboratory is equipped with a GeneXpert system to perform HPV tests and all necessary equipment to do further pathology tests. With screening clinics available throughout the country, UCI is capable of conducting the project in any part of the country.
Impact areas where we are working
|Epidemiology Summary||Country data|
|Female population aged 20-29 (million)||3.97|
|Female population aged 30-59 (million)||5.02|
|HPV prevalence (%)||10.2% – 40%|
|Cervical cancer incidence rate (crude, per 100 000)||30|
|Cervical cancer incidence rate (age-standardized, per 100 000)||56.2|
|Cervical cancer mortality (crude, per 100 000)||19.9|
|Cervical cancer mortality (age- standardized, per 100 000)||41.4|
|Available/recommended method of screening||VIA|
|Type of screening||Opportunistic|
|Is there a national strategy/program dedicated to cancer?||No – potentially substituted by UCI Strategic Plan 2015/16 – 2019/20|
|Is there a national strategy/program dedicated to cervical cancer?||Unlikely – latest available program dated 2010-2014|
|Target age group in the project (years)||25 – 49|
Some of our activities in Uganda
In Uganda both organisations have experience communicating through door to door by Village Health Teams. Both can work on informative and entertaining content. Eg.: UCI with a Cancer Awareness Magazine and URDT with a Music Dance and Drama related to what we want to communicate.
Field visit Dr. Jogchum Beltman
News from Uganda
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