May 2014

In Lesotho, EGPAF Provides Critical Cervical Cancer Services

Created by:

Dr. Oluwasanmi Akintade



Seven years ago, when I first moved to Lesotho, more than 23 percent of the adult population was living with HIV. Today, the country still has the second highest HIV prevalence rate in the world, which – combined with many other factors affecting maternal and child health – places a huge burden on its national health system.

I moved to Lesotho to support the National Referral Hospital’s obstetrics and gynecology department and in that role I was particularly focused on the health of Lesotho’s women. Women infected with HIV have a higher prevalence of pre-cancer lesions on the cervix, which can rapidly progress to cervical cancer.  And because cervical cancer is the leading cause of cancer-related deaths for women living in Lesotho, it was imperative that we screened early and often.

But despite the intersection of these diseases, Lesotho was challenged with launching an organized and cohesive process for screening and preventing cervical cancer. That changed in 2013 when the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), with funding from the U.S. Agency for International Development (USAID) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR),  helped the government launch services at the Senkatana Center of Excellence, Lesotho’s first-ever organized cervical cancer screening and prevention facility.

Now, in my role as EGPAF’s reproductive health director, I lead a passionate and dedicated group of health professionals to address the intersection of cervical cancer and HIV.

Located in the Botshabello Hospital complex in Maseru, Senkatana now offers comprehensive gynecological services, with an emphasis on cervical cancer screenings, diagnoses, pre-cancer treatment services, and referrals to facilities for cancer treatment. Since opening in January 2013, we have screened more than 2,300 women, the majority of whom had never been screened for cervical cancer in the past.  Given the delay in processing test results, most clients are screened using Visual Inspection with Acetic Acid (VIA), a cost effective alternative whose results are immediately available.

Because the center provides a full range of services, clients are also offered breast exams, HIV testing and counseling for those who do not know their status, and screening for sexually transmitted infections (STIs). Other at-risk groups are also screened for diabetes and hypertension. 

Prior to the launch of cervical cancer services at Senkatana in 2013, I worked with Lesotho’s Ministry of Health to develop national guidelines, resources, and standards of practice for cervical cancer screenings. We then used these materials to create a comprehensive training package for health care providers on the prevention of cervical cancer and other reproductive health topics. The Ministry of Health kindly provided nurses to staff the cervical cancer prevention center.

As I look toward the next few years, I am incredibly excited about EGPAF’s plans to offer our cervical cancer training package to health workers at the district and health facility level.

The Senkatana nurses, who are now the country’s leading experts in cervical cancer screening and prevention, will serve as mentors for district and facility teams to launch screening programs in their own districts. As we continue to expand our cervical cancer programs, Senkatana will serve as the country’s referral center for women screened at the facility or district level who are in need of a higher level of care.

In all that we do, we look for ways to provide new and innovative treatment options to the people of Lesotho. Whether it’s through electronic medical records, or innovative methods to support Senkatana’s wide range of HIV, tuberculosis (TB), and cervical cancer programs, EGPAF is committed to providing an excellent standard of care for the people of Lesotho.

We know when you prioritize the health of a family, you create a healthy community.

And we will continue working toward that goal, until no child has AIDS.

Oluwasanmi Akintade, M.D. is EGPAF-Lesotho’s director of reproductive health. He pioneered EGPAF’s cervical cancer screening program at the Senkatana Center of Excellence.