Strengthening Capacity of Healthcare Workers to Fast-Track Cervical Cancer Elimination in Eswatini
Eswatini faces one of the highest burdens of cervical cancer globally. In response, the World Health Organization (WHO) Country Office has supported the Ministry of Health in the development and ongoing implementation of the Cervical Cancer Elimination Acceleration Plan (2024–2028). This plan aims to achieve the 90–70–90 targets by 2030, in alignment with the WHO Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem.
“The Ministry of Health (MOH) has embarked on a task-sharing initiative to build the capacity of nurses to perform LEEP procedures, with doctors providing ongoing mentorship and support at hospital and health center levels. Meanwhile, HPV testing, Visual Inspection with Acetic Acid (VIA) services have been decentralized to primary care facilities and laboratories” Ms Xolisile Dlamini National Cancer Control Unit Program Manager – MOH
On 24 October 2025 – The World Health Organization (WHO) Country Office in Eswatini, in collaboration with Eswatini’s Ministry of Health and with technical support from the WHO Regional Office for Africa (AFRO), organized a comprehensive Loop Electrosurgical Excision Procedure (LEEP) training program for healthcare workers (HCWs). The training aimed to strengthen national capacity for the treatment of cervical precancerous lesions, aligning with the third pillar of the Global Strategy to Eliminate Cervical Cancer as a Public Health Problem. Held over 10 days from 6 to 17 October 2025, the program combined theoretical and hands-on clinical components, resulting in enhanced technical knowledge, improved procedural skills, and greater adherence to WHO-recommended standards.
“The training equipped health care workers’ with the necessary technical skills and decision-making capacity for appropriate indication and referral of precancer treatment; aligning LEEP and thermal ablation procedures with WHO guidelines; reinforcing infection prevention and control measures and patient safety; and promoting the integration of cervical cancer treatment services within primary health care (PHC) settings,” Dr. Dille, Surgical Oncologist and Regional Advisor on Cancer for the WHO Regional Office for Africa.
The training was co-organized by WHO and Eswatini’s National Cancer Control Unit (NCCU) – MOH combining two days of theoretical sessions with seven days of supervised hands-on practice across three clinical sites including Phocweni Clinic, AHF Clinic, and Chakaza Clinic and one overall training debrief and planning session. A total of 31 healthcare workers (HCWs), including doctors (8) and nurses (23) , participated in the sessions, covering modules on anatomy, screening (VIA/VILI), pre-cancer treatment ( thermoablation, and LEEP), infection prevention and control (IPC), pathology, and data management.
More than 80 procedures were performed across the three training sites, including over 33 LEEPs , one thermal ablation and three biopsies thus clearing the backlog which was existing prior to training. One minor complication (bleeding) occurred and was managed successfully according to WHO-recommended clinical protocols.
“The training has contributed to improved clinical decision-making regarding lesion assessment, treatment eligibility, and appropriate referral. In addition coordination and communication between screening, treatment, and pathology services have been significantly strengthened” Dr Teluleko Maseko , National Cervical cancer Coordinator MOH.
The course enhanced HCWs’ knowledge and practical skills, ensuring better case selection for pre-cancer treatment and more consistent referral practices.
Discussions during the training emphasized the need to establish a National Cervical Cancer Task Force and to revise national screening and treatment guidelines based on WHO standards, which will serve as critical next steps to sustain national progress toward elimination.
The Eswatini training marks a major milestone in strengthening the third pillar of the cervical cancer elimination strategy. It demonstrated that targeted capacity building can transform service delivery and accelerate elimination progress, even in settings with a high burden. The establishment of a national task force and guideline revision will institutionalize the’ outcomes of the training, ensuring sustainability and policy integration.
Next steps include trained participants to conduct a Total of 30 LEEP cases in order to get certified by March 2026, integrating data into DHIS2, and establishing mentorship and quality assurance frameworks.
“The LEEP training in Eswatini, facilitated by WHO, exemplifies how national and regional collaboration, evidence-based training, and government ownership can translate the Global Strategy for Cervical Cancer Elimination into action. It stands as a success story for the WHO African Region, proving that with partnership, commitment, and technical excellence, even the highest burden countries can advance toward elimination,” Dr. Susan Tembo, WHO Eswatini Representative.
Distributed by APO Group on behalf of World Health Organization (WHO) – Eswatini.
