Plan Strategique National De Lutte Contre Le Cancer 2022-2025

Objectives

The National Cancer Control Plan 2022–2025 seeks to reduce mortality from prevalent adult and childhood cancers in Côte d’Ivoire by 10% by 2025, advancing a vision in which cancer becomes a controllable chronic disease within an accessible, resilient and high-performing health system.[1][2]It is aligned with the 2021–2025 National Health Development Plan and broader global commitments on non-communicable diseases.[3][4][5]

• Strengthen governance, legislation, coordination and efficient financing for cancer control across all levels of the health system.[1][6][7]
• Expand equitable access to quality prevention, diagnosis, treatment, palliative, psychosocial and nutritional care, especially for vulnerable populations.[1][7][8]
• Improve cancer information, surveillance, research, planning, monitoring and evidence use for decision-making.[9][6][10]
• Reduce modifiable risks through tobacco and alcohol control, healthier diets, physical activity, vaccination and community awareness.[11][12][13]
• Prioritise prevention, early detection and treatment for breast, cervical, prostate, colorectal and childhood cancers, while addressing other prevalent cancers including liver cancer.[14][15][16]
• Increase human papillomavirus vaccination, cervical screening, mammography and colorectal screening, alongside earlier referral and treatment initiation.[4][16][17]

The plan is organised around three strategic axes: strengthen governance and financing; strengthen the provision of and access to quality cancer services; and strengthen health promotion for cancer control.[6][18][19]Expected results cover effective governance and financing, production and use of quality health information, improved service quality and accessibility, and increased adoption of appropriate preventive behaviours and service use.[1][20][4]

Key 2025 ambitions include increasing the health-sector budget share for cancer control from 1.15% in 2021 to 2.50%, expanding functional public medical oncology units from five to seven, increasing functional cancer centres from one to two, raising treatment initiation from 40% to 80%, and expanding palliative-care access towards full coverage.[1][20][21]The plan also targets increased human papillomavirus vaccination, cervical screening, mammography and colorectal screening, although extracts present differing vaccination target values.[4][16][17]

Implementation

Implementation uses a whole-of-health-system and multisectoral model led by the Ministry of Health, Public Hygiene and Universal Health Coverage and the National Cancer Control Programme, combining service strengthening, community mobilisation, health-information improvement, research, financial protection and partner engagement.[22][6][7]Delivery is intended to operate throughout the health-system pyramid and involve public and private providers, communities, civil society, professional bodies, development partners and other government sectors.[23][24][25]

• Establish a steering committee under the Director General of Health to guide implementation, mobilise resources and assess results at least annually.[26]
• Operate an implementation monitoring committee, chaired by the Director General of Health, to set annual orientations, validate progress reports and report to the steering committee at least twice yearly.[26]
• Operate a technical monitoring committee, chaired by the cancer-control directorate, to validate annual operational plans, coordinate delivery and consolidate reports at least quarterly.[27]
• Reactivate regional cancer-control committees and conduct coordination and review meetings at central, regional and departmental levels.[26]
• Prepare annual operational plans, undertake a mid-term evaluation and conduct a final evaluation of the plan.[26][28]
• Strengthen technical working groups for cervical, breast and childhood cancers, multidisciplinary consultation meetings, stakeholder coordination and advocacy capacity among cancer-control associations.[29][30]

Service delivery combines prevention and early detection with strengthened diagnostic, treatment and supportive-care capacity. Planned actions include developing cancer registries and digitised data systems, upgrading public cancer-care and pathology facilities, creating oncology capacity in Bouaké, constructing the National Medical Oncology and Radiotherapy Centre at Grand-Bassam, improving access to medicines and morphine, and expanding surgery, radiotherapy, chemotherapy, palliative care and tele-expertise.[9][10][31][28][32]Community health workers, traditional medicine practitioners, local leaders, media and civil-society organisations are expected to generate demand, communicate prevention messages and support referral.[33][34][2]

Monitoring is designed around impact, outcome, effect and output indicators using routine health information, surveys, studies, cancer registries, programme reports and the District Health Information Software 2 platform.[35][26][36]Priority measures include mortality, late diagnosis, treatment initiation, access to treatment and palliative care, medicine availability, service capacity, workforce, vaccination, screening, population sensitisation, financing and governance.[1][20][37]Data-quality controls, quarterly validation meetings, annual cancer situation reports, policy briefs and research dissemination are planned to strengthen accountability and evidence use.[9][31][28]

The estimated implementation cost is 166.51 billion West African CFA francs, approximately 260.17 million United States dollars, for 2022–2025.[38][5]Costing uses an ingredients-based approach covering medicines, supplies, training, supervision, monitoring and evaluation, equipment, advocacy and communication.[39][38]Financing is expected to draw primarily on State operating and investment budgets, supplemented by development partners, private-sector participation, public-private partnerships, innovative domestic mechanisms and a proposed national cancer-control fund.[7][34][40][30]

Monitoring & Evaluation

The plan establishes a results-based monitoring and evaluation system to track progress towards reducing mortality from prevalent adult and childhood cancers by 10% by 2025. It combines routine health information, cancer registries, surveys, studies, supervision, annual reviews and mid-term and final evaluations.[1][26][27]

• Monitor impact, outcome, effect and output indicators, with targets for at least 50% of effect indicators and 75% of output indicators to achieve their targets by 2025.[1][20][41]
• Track mortality, late diagnosis, treatment initiation, access to anti-cancer treatment and palliative care, medicine-order fulfilment, staffing, vaccination, screening, governance, financing and service utilisation against stated baselines and targets.[1][20][4][37]
• Use the National Health Information System, District Health Information Software 2, routine data, surveys, the Abidjan Cancer Registry, planned registries including Bouaké, Globocan 2020, programme activity reports and National Public Health Pharmacy data.[42][9][26][36][37]
• Improve data quality through revised indicators and collection tools, digitalisation, quarterly cancer-data validation meetings, archiving, feedback between levels, integration of university-hospital data, timely dissemination and stronger information-management capacity.[9][43][31]
• Produce annual operational plans, annual review reports, cancer situation reports, policy briefs and research outputs, and conduct a final evaluation before developing the subsequent multi-year cancer-control plan.[36][44][31][28]
• Address surveillance gaps by expanding cancer registration beyond Abidjan and improving evidence on lifestyle risks, access to care, treatment of cervical precancerous lesions, air pollution, occupational risks and inherited cancers.[45][46][9][47][48]
• Strengthen accountability through a steering committee chaired under the authority of the Director General of Health, an implementation monitoring committee meeting at least twice yearly, and a technical monitoring committee meeting at least quarterly to validate plans, consolidate reports and escalate progress to the steering committee.[26][27]
• Conduct periodic central, regional and departmental coordination and review meetings, alongside annual financial audits, periodic financial reporting and controls by the General Health Inspectorate, General Inspectorate of Finance and State Inspectorate.[39][26]

Costing & Financing

The National Cancer Control Plan for 2022–2025 is costed at 166.51 billion West African CFA francs, approximately 260.17 million United States dollars. Costing used an ingredients-based approach in Microsoft Office Excel 2016, covering inputs for interventions across the three strategic axes, including medicines, supplies, training, supervision, monitoring and evaluation, equipment, advocacy, communication and awareness.[39][38][5]

• Allocate the largest identified annual financing requirement to 2024, at 136,559,837,643 West African CFA francs; the documented total requirement across 2022–2025 is 166,508,870,864 West African CFA francs.[38]
• Increase the health-sector budget share allocated to cancer control from 1.15% in 2021 to 2.50% by 2025.[21]
• Finance implementation through State operating and investment budgets, partner resources, public-private partnerships, innovative domestic financing, a proposed cancer-control fund and advocacy to private-sector and development partners.[7][34][40][41]
• Integrate interventions into the Multiannual Expenditure Programming Document-Annual Performance Project and the Public Investment Programme.[40]
• Address financial barriers to care, including substantial household direct payments, exclusion of cancer from the Universal Health Coverage benefit package, costly oncology medicines, insufficient financing for data systems and research, and treatment costs for cervical precancerous lesions.[49][9][43][50][51][52][53]
• Recognise that the extracts do not specify confirmed financing by source, a quantified funding gap, or detailed economic assumptions beyond the costing methodology, resource-mobilisation measures and stated budget targets.[39][38][5]