Cancer is a generic term for a large group of diseases that can affect any part of the body. One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs. This process is referred to as metastasis. Metastases are the major cause of death from cancer. Tobacco use, alcohol use, unhealthy diet and physical inactivity are the main cancer risk factors worldwide. Chronic infections from hepatitis B (HBV), hepatitis C virus (HCV) and some types of Human Papilloma Virus (HPV) are leading risk factors for cancer in countries like Malawi. Cervical cancer, which is caused by HPV, is a leading cause of cancer death among women in Malawi.
Msyamboza et al (1912) reported a total of 18,946 new cases of cancer registered in 81 of the 84 main health facilities in Malawi during the period 1st January 2007 to 31st August 2010. Of the 10.541 new cases among females registered during the period under review 45.4% were cancer of the cervix.
Current health promotion emphasis:
Disability including Mental Illness
The prevalence of disability in Malawi, as defined by the ICF model, is 4.18%. This is higher than earlier estimates of 2% in 1983 and 2.9% in 1993. Ntchisi District has the highest prevalence of disability at 7.79% and the lowest in Mchinji at 1.20%. The most common types of disabilities are physical disabilities (43%) followed by seeing (23%), hearing (16%) and intellectual/emotional disabilities (11%), communication disabilities (3%) and old age (1%). Other types of disabilities constituted 3% of the sample population. Nearly half of these disabilities were due to physical illness. The other major causes of disability were natural/from birth (17%) and accidents (10.6%). Nearly 7 in 10 respondents became disabled at less than 20 years of age. In terms of health services, even though respondents mentioned that they needed the services, a significant proportion of respondents did not receive the services. For example while 84% of the respondents were aware of health services and about the same proportion expressed the need for such a service, only 61% received health services. These results generally demonstrate that even though services may be available and the Constitution and the MGDS call for provision of services to all Malawians, PWDs have barriers to accessing health services because of their disability.
Mental illness interventions were not part of the EHP under the PoW 1. It is estimated that Fourteen percent of the global burden of disease can be attributed to neuropsychiatric disorders with around 20% of the world's children and adolescents are estimated to have mental disorders or problems, with similar types of disorders being reported across cultures. In Malawi the majority of patients with common mental health problems present in primary health centers and one study involving 22 health centers with outpatient facilities in Machinga district and 3487 patients attending the health centers, found that 28.8% had a common mental health problem and 19% had depression with all of them not being detected and going untreated at baseline before trainings of primary health workers.
The availability of skilled mental health workers is minimal with there is 100% vacancy rates for clinical and one position for consultant psychiatrist filled . Service level agreements exist with St John of Gods in Mzuzu in the North.
The country has a graduate psychiatric nursing course in Mzuzu graduating 10-12 nurses each year, and training in clinical psychology is currently under development.