Gynecologic Oncology Sub-Specialty Training at Komfo Anokye Teaching Hospital (KATH) in Ghana: Overcoming 21st Century Challenges with Global Partnerships. Frontiers in Public Health
Anna Sarah Erem, Adu Appiah-Kubi, Thomas Okpoti Konney, Kwabena Amo-Antwi, Sarah G. Bell, Timothy R. B. Johnson, Carolyn Johnston, Alexander Tawiah Odoi and Emma R. Lawrence
The leading cause of cancer deaths in Ghanaian women is cervical cancer in part due to late presentation. This, in addition to the chronic late presentation of other gynecologic malignancies, demonstrates a crisis surrounding women’s health in Africa. As a collaboration of US and Ghanaian medical professionals, our paper investigates methods of improving health outcomes for women in Ghana. The gynecologic oncology fellowship program we discuss was developed as part of a longitudinal, multi-decade, partnership between the University of Michigan (MM) and the Ghana College of Physicians and Surgeons. The goal is to establish an in-country sustainable training program to address the challenge of “brain drain” while building a culturally relevant capacity for gynecologic oncology education and care. We compare this program to other gynecologic oncology initiatives on the African continent and explore the positive and negative aspects of each. The research includes analysis of feedback from fellows in the program as well as the patients they serve. Our paper will demonstrate that the Ghanaian/ MM model for gynecologic oncology sub-specialty training is the most expedient and effective way to assist Ghanaian women. Our hope is that it can serve as a guide for sub-specialty medical education in other LMIC.
Accepted to publication in an upcoming Special Edition of Frontiers in Public Health on 11/06/20
Research Topic: “Trends and Challenges of Medical Education in the Changing Academic and Public Health Environment of the 21st Century”
Use of MRI in the management of diagnostic uncertainty in low-resource settings: A case report of cesarean ectopic pregnancy in a tertiary hospital in Ghana
In the last 30 years, women’s healthcare in Ghana has undergone an enormous transformation. Initially a collaboration with the University of Michigan, the Carnegie Corporation, and Ghana teaching hospitals set up the first OBGYN residency program. Since that point in 1989, the curriculum has evolved, the Ghana College of Surgeons and Physicians has taken an active role and 246 residents have passed through the program. This improvement in OBGYN training has led to an increased volume in procedures such as Cesarean Sections (CS), a trend seen across low to middle-income countries (LMIC). The management of CS complications, such as Cesarean Scar Ectopic Pregnancy (CSEP), is thus becoming a crucial piece of the education needed to prepare upcoming OBGYN’s, pathologists, and radiologists before they enter the workforce. Although, there is an intimidating amount of data that continues to accumulate in various subspecialties regarding this topic, very little is written about the management of CSEP in LMIC such as Ghana. Our case report investigates the well-accepted risk factors, the appropriate sequence of diagnostic procedures, and its possible optimization in low-resource settings.