Abstract:
Following an upsurge in cervical cancer incidence and mortality, Ethiopia developed its first
National Cancer Control Plan (NCCP) to support efforts toward the prevention and control of
cancer. The NCCP outlines strategies for reducing the incidence of cancer through prevention, screening, early diagnosis, treatment, and palliative care. This study examined barriers
and facilitators to the implementation of the NCCP using a qualitative approach. The study
entailed doing key informant interviews and reviewing secondary data. Using customized
topic guidelines, fifteen interviews were conducted covering a wide range of topics, including
political commitment, priority setting, interagency cooperation, the role of evidence, citizen
empowerment, and incentives. All interviews were recorded (with consent), transcribed in
Amharic, and then translated into English for thematic analysis. Review of secondary data
focused on establishing the NCCP’s implementation status for HPV vaccination, cervical
cancer screening, and treatment, and strategic links to five other national policy documents
centered on public awareness, cervical cancer services, HPV immunization, and sexually
transmitted infections control. We found that in 2022, 55% of eligible Ethiopian women were
screened for cervical cancer (against the annual target), with roughly half of those with a
positive result receiving treatment. Overall, 900,000 (8.4%) of the 10.7 million eligible
women in the country underwent screening. The study revealed inadequate implementation
of the NCCP strategies toward achieving the WHO’s 90-70-90 cervical cancer targets by
2030. A key positive strategy was the involvement of high-ranking government officials in
the National Cancer Committee, which aided the NCCP implementation. On the other hand,
inadequate political support, funding constraints, suboptimal public messaging, lack of
incentives, and inadequate partnership arrangements emerged as important barriers. We
recommend that decision-makers intensify coordinated efforts, prioritize dealing with identified challenges and optimizing facilitators, and mobilize additional resources to enhance cervical cancer services in Ethiopia
