The State of Cervical Cancer Screening in Imprisoned Women in Malawi: A Case of Maula Prison.

Abstract Background: Malawi is one of the countries with the highest burden of cervical cancer in the world with less than ten percent of women screened for cervical cancer. The study aimed to investigate the state of cervical cancer screening among incarcerated women at Maula prison. Findings of this study provide knowledge of the challenges that prisoners face when accessing screening services so that relevant policies and strategies may be developed to address the challenges.Methods: The study employed a cross-sectional qualitative study design. A total of 31 prisoners aged between 18 to 49 participated in the study. Among these, 15 women participated in in-depth interviews, while 16 women participated in two focused group discussions consisting of 8 women per group. All interviews were recorded and transcribed verbatim. Data was analysed using a thematic content analysis approach. Results: All participants were knowledgeable of cervical cancer. Screening services were periodically provided in the prison. Early diagnosis and treatment were the key benefits for undergoing screening. Poor environment consisting of poor living conditions, sanitation and hygiene, Preference of female health practitioners during screening and poor treatment by prison officers & health care givers when accessing care were reported as challenges that affected screening uptake in the prison. Conclusion: Incarcerated women experience gender-specific health-related challenges, including menstruation, pregnancy and development of certain forms of cancer that affect their sexual reproductive health. The prison culture hinders prisoners from receiving quality care while in incarceration. Better living conditions, environment and policies must be put in place to support screening uptake among this population.