Cross section of participants during the PEER Cervical Cancer Screening and Preventive Therapy project launch in April 2019.

As cervical cancer continues to wreak havoc among Malawian women, the training of 18 health workers from 8 health facilities in Lilongwe District in cervical cancer screening and preventative therapy commenced at UNC Project’s Tidziwe Centre in Lilongwe from 9 to 20 September 2019. In Zomba District, 29 participants from 7 health facilities were also trained. These trainings were sponsored by a Partnerships for Enhanced Engagement in Research (PEER) Cervical Cancer Screening and Preventive Therapy-funded project.

The cadres of health professionals who participated in these trainings included nurses, clinical technicians and medical assistants.

The training concentrated on training nurses and clinicians in two areas, namely: Cervical Cancer Screening using visual inspection with acetic acid (VIA) and treatment of precancerous lesions with Thermocoagulation. Thermocoagulation is currently being introduced across Malawi as an alternative treatment to cryotherapy because it has been found to be just as effective, but faster and easier to use.

Around the same time, a Malawi Ministry of Health-organized workshop also took place in Dowa district from 9 to 13 September 2019, which was co-sponsored by the UNC PEER project. Cervical cancer partners were able to bring information, education, and communication (IEC) materials they had been using for cervical cancer awareness to the meeting and work with the MoH to review and develop new IEC materials during this meeting.

Launched in April 2019, the PEER project is funded by the United States Agency for International Development (USAID) and National Academies of Science (NAS), and is being led by UNC and the University of Malawi-College of Medicine, with Management Sciences for Health; the Centre for Health, Agriculture, Development Research and Consulting; and the University of Washington as partners.

According to Clinical Site Research Leader at UNC Project-Malawi Dr. Lameck Chinula, the PEER project is designed as a cluster randomized trial integrating human papillomavirus (HPV)-based screen-and-treat algorithm with voluntary family planning (VFP) services. This project will evaluate the feasibility, acceptability, uptake, and cost-effectiveness of the integration.

There are two models which will be evaluated in the project: In Model 1, cervicovaginal self-sampling for rapid HPV testing will be offered in clinics. On the same day, thermocoagulation will be conducted to treat the women found to be HPV+.

In Model 2, similar procedures will be followed, but the difference is that the self-sampling will also be offered at home or in their community, and not only at the clinic as in Model 1. Thermocoagulation treatment at the clinic will follow if women are found to be HPV+.

There have been media reports in Malawi suggesting that cervical cancer exposes women to exclusion, with some being expelled from marriage or enduring insults from their surroundings because of effects of the disease.

Earlier in the year, the Malawi Ministry of Health indicated that in 2018 alone, the country registered 4163 new cases of cervical cancer among women, and 2879 died from the disease.