A Solutions Based Approach to Problem Solving

Africa Cancer screening Cervical cancer Cervical Cancer Prevention Global Health Pap Smear Public health Policy women's health

For many years I have lamented the lack of trained health workers in Ghana to treat precancerous lesions of the cervix. A handful of gynecologists in Ghana are equipped with the skill to treat precancerous lesions of the cervix with Loop Electrosurgical Excision Procedure (LEEP). This is an essential component if Ghana will win the fight against cervical cancer. Precancerous lesions of the cervix need to be treated so that they don’t develop into cancer.

In January 2020 (celebrated as cervical cancer awareness month in Ghana), I proposed to the Society of Obstetricians and Gynecologists of Ghana (SOGOG), among other things, to engage the Faculty of Obstetrics and Gynecology in the Ghana College of Surgeons to make training in management of precancerous lesions of the cervix (especially with LEEP) a priority, as cervical cancer remains a major problem in Ghana. I had written about this a couple of years earlier.

Age Standardized Rates of Cervical Cancer by Country – Source: IARC International Agency for Research in Cancer

If we cannot get enough gynecologists in Ghana to treat precancerous lesions of the cervix with LEEP, all is not lost. I think the Faculty of Family Medicine in the Ghana College of Physicians and Surgeons can take this up. This can be incorporated into their training program so that a good number of family physicians come out with the skills to tackle this problem across the country.

In 2017, Dr. Theodora Pepera, gynecologist and colposcopist/colposcopy trainer in London was in Catholic Hospital, Battor to run a colposcopy course with Dr. Miren Turner, a primary care specialist, and Ms. Joyce Aburam, a Ghanaian who is a nurse colposcopist in London. Both Dr. Turner and Ms. Aburam are certified colposcopists and perform LEEPs in the UK. This shows that other health workers other than gynecologists can be used to solve the problem, and this has worked elsewhere.

The most important thing is for us to solve our problems. When our system does not make it possible to produce adequate anesthesiologists (physician anaesthetists) across the country, nurse anesthetists (did I get the name right?) will take up the role. The faculties in the Ghana College of Physicians and Surgeons have a big role in which direction we go as a country.

By Dr. Kofi Effah a gynecologist and head of the Cervical Cancer Prevention and Training Center in Catholic Hospital, Battor in the Volta Region of Ghana.

Click this link for cervical cancer screening sites in Ghana


A physician providing primary medical care to patients across the lifespan