Nigeria Cancer Plan 2008–2013

Objectives

Nigeria’s National Cancer Control Plan sets out an integrated, coordinated five-year framework for reducing cancer incidence, morbidity, mortality and socio-economic impact, while improving health and quality of life for people living with cancer.[1][2]It seeks to address rising cancer burden through prevention, early detection, diagnosis, treatment, rehabilitation, palliation, healthy-lifestyle promotion, environmental-risk reduction and regulation of appropriately equipped health facilities.[3][2]

• Increase public awareness, information dissemination, education and nationwide outreach, alongside prevention initiatives addressing breast, cervical, colorectal, prostate, liver, lung and skin cancers in albinos, as well as leukaemia.[4][5]
• Strengthen cancer training for health-care providers and advocates, including oncology nursing, radiology, pathology, surgical, medical, paediatric and radiation oncology, psycho-oncology and pain control.[5][6]
• Improve prevention, early detection, diagnosis and treatment through standardised guidance, referral systems, quality assurance and specialised cancer centres across all geopolitical zones.[3][6]
• Document the location and quality of cancer facilities, staffing and services, and establish policies and regulations to support quality cancer care.[3][7]
• Increase cancer research capacity, funding, collaboration and dissemination of findings through national and international channels.[3][7]
• Strengthen surveillance through institutional, state and zonal population-based registries feeding into a national database.[3][8]
• Facilitate collaboration among public and private cancer stakeholders and ensure quality palliative care, including pain control, for people living with cancer.[3][8][9]

Implementation

The plan adopts a coordinated national cancer-control model designed for a resource-constrained setting, combining public education, prevention, early diagnosis and referral, effective treatment, rehabilitation and palliative care.[1][2]The Federal Ministry of Health has a central coordinating role, supported by multidisciplinary professionals, health institutions, government bodies, communities, civil-society organisations, research bodies and international partners.[4][7][8][9]

• Coordinate development and implementation through the National Consultative Committee on Cancer Control, inaugurated by the Federal Ministry of Health in October 2006, and seven subcommittees covering current cancer care, multidisciplinary treatment, continuing medical education and research, palliative care, quality control and assurance, awareness and advocacy, and cancer registration.[4]
• Deliver prevention and awareness activities through community health departments, clinics, pharmacies, schools, media, internet resources, national cancer-awareness activities in October, World Cancer Day, public education materials, tobacco control and healthy-lifestyle messaging.[5]
• Integrate prevention into primary health-care services through hepatitis B and human papillomavirus vaccination and training of primary health-care workers in cancer screening.[5]
• Develop training curricula, expand practical cancer content in health-training institutions, facilitate local and regional oncology training, and publish directories of cancer-education and continuing-professional-development providers.[6]
• Establish national directories of specialist institutions and referral sources, assess service gaps and overlap, define referral criteria, develop uniform screening and treatment guidance, and implement quality-assurance mechanisms covering management, ethics, equipment, infrastructure, materials and cancer medicines.[6]
• Support and expand cancer registration by developing national guidelines, strengthening histopathology services, training registry staff with international partners, collecting population and risk-factor data, registering death certificates, and coordinating registry data sharing.[8]
• Produce an annual national cancer report from October 2008 and use a cancer-registry subcommittee and strengths, weaknesses, opportunities and threats analysis to inform oversight and planning.[8]
• Strengthen research through centres of excellence, resource mobilisation, funding-opportunity databases, grant-writing support, peer-reviewed publication and conferences.[7]
• Expand palliative care by establishing hospital and community hospices in all geopolitical zones, developing the trained pain-control workforce, providing continuing education and advocating removal of restrictions on narcotic-analgesic imports.[9]
• Engage Federal and State Ministries of Health, local government authorities, the National Primary Health Care Development Agency, the National Agency for Food and Drug Administration and Control, professional associations, universities, non-governmental organisations, the Nigerian Cancer Society, hospices and international organisations including the World Health Organization, International Agency for Research on Cancer and International Atomic Energy Agency.[5][6][7][8][9]

Monitoring & Evaluation

Cancer surveillance is positioned as a core mechanism for defining public-health priorities, planning comprehensive cancer control and assessing progress. The plan responds to major data limitations, including underreporting, inadequate diagnosis, limited access to care, uneven technical capacity and infrastructure, and weak cancer-data systems.[3][2]

• Strengthen population-based surveillance through institutional, state and zonal cancer registries that contribute to a national cancer database.[8]
• Reactivate the National Cancer Registry in accordance with international guidance, establish additional registries and upgrade existing registry capacity.[4]
• Register cancer facilities with the National Headquarters of Cancer Registries in Nigeria and establish regional and national registration centres to improve documentation of facilities, workforce and services.[6]
• Collect and collate population data, cancer risk factors, relevant infections including hepatitis B virus and Helicobacter pylori, and death-certificate information.[8]
• Survey secondary healthcare institutions and other cancer-data sources, assess national information needs, and develop arrangements for data sharing and coordination among registries.[8]
• Produce and disseminate an annual national cancer report, beginning in October 2008, to support oversight and planning.[8]
• Support accountability through national directories of cancer institutions and referral sources, assessment of referral gaps, compliance monitoring for uniform screening guidance, and quality-assurance systems covering cancer management and ethical practice.[6]
• Use a cancer registry sub-committee and strengths, weaknesses, opportunities and threats analysis to inform national oversight and planning.[8]

Available 2002 estimates from the World Health Organization International Agency for Research on Cancer gave all-site cancer incidence rates of 90.7 for males and 100.9 for females, and mortality rates of 72.2 and 76.0 respectively; these estimates are qualified by the completeness and accuracy of underlying national data.[2]Detailed quantitative indicators, targets, reporting schedules, evaluation procedures and clearly assigned monitoring responsibilities are not specified in the supplied material.[2][6]

Costing & Financing

The plan recognises that cancer-control interventions must be affordable and accessible in a resource-constrained setting.[1]It identifies increased funding for cancer-control research and resource mobilisation as strategic needs, but provides no quantified overall budget, costed implementation framework, expenditure allocation or funding-gap estimate.[3][7]

• Mobilise and allocate resources for cancer research, publicise funding opportunities, maintain a database of public and private funding agencies, and strengthen research grant-writing capacity.[7]
• Support resource-intensive priorities including hepatitis B and human papillomavirus vaccination, screening, workforce development, specialised cancer centres, referral coordination, quality assurance, equipment, infrastructure and cancer medicines.[5][6]
• Develop registry systems, strengthen histopathology services, train registry personnel, support research centres of excellence, and establish hospital and community hospices across geopolitical zones.[7][8][9]
• Expand the trained workforce for pain control and pursue removal of restrictions affecting the importation of narcotic analgesics.[9]

Funding sources, financing mechanisms, resource-mobilisation targets, unit costs, economic assumptions, specific allocations and quantified gaps are not specified in the supplied material.[1][2][5][6][7][10]