Behind the Science: Enhancing Cervical Cancer Screening in Rwanda

Interviewee: Dr. Katherine Gray; UBC Obstetrics and Gynaecology resident, PGY-2 | Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinators)

Published: July 5th, 2024

Can you tell me about your research?

I am a first year resident in Obstetrics and Gynecology (Ob/Gyn) at the University of British Columbia (UBC). I started doing global health research within the theme of women’s health in my fourth year of medical school. My research focused primarily on equity and care surrounding women’s health in Rwanda.

I initially delved into a project centered around enhancing access to cervical cancer screening for women in Rwanda. Since then, my endeavors have expanded to various projects within the realm of Ob/Gyn care in Rwanda. One noteworthy initiative I spearheaded was the optimization of cervical cancer screening and accessibility in Rwanda by gaining insights from healthcare providers. My study, which concluded last year, looked at the practices of Ob/Gyns, nurse midwives, and family doctors regarding cervical cancer screening, shedding light on the challenges they encounter.

Additionally, I’ve been involved in diverse research themes in Rwanda, including an exploration of preterm premature rupture of membranes and the existing guidelines, comparing them to Canadian standards of care. I’ve also investigated operative vaginal deliveries in Rwanda, and my current focus lies on various facets of cervical cancer screening.

Are there any findings from your research that you’d like to highlight?

From my study on healthcare provider perspectives, a lot of the findings did align with similar studies in other low-resource settings. One prominent theme that emerged is the significant barrier posed by patients’ knowledge and education levels regarding cervical cancer and screening. Many patients exhibit a limited understanding of either the disease or the screening process, which limited their engagement with screening initiatives.

Additionally, the training of healthcare providers in conducting cervical cancer screening emerged as another influential factor in accessing screening. A small subset of physicians and nurses receive formal training on how to conduct screening, leading to a shortage of proficient providers. This shortage of trained professionals was consistently cited as a barrier to screening by every provider interviewed in my study. Overall, the training landscape appears inconsistent, resulting in notable gaps in screening and subsequent care provision.

How did you get involved with this kind of work?

In my fourth year of medical school, I knew that I wanted to pursue Ob/Gyn and I have always been interested in global health. I was connected with my research supervisor, Dr. Marianne Vidler and got involved with her work and the theme of global health and maternity care in Rwanda. I have been interested and involved ever since! I am immensely grateful for the opportunity to continue my residency at UBC, as it enables me to sustain my research endeavors alongside my exceptional team, both in Canada and Rwanda.

What impact do you hope to see with the work you’re doing?

My research is dedicated to identifying and understanding the barriers hindering both patients from accessing care and providers from delivering it effectively. By comprehending these obstacles, we aim to take proactive steps towards enhancing screening accessibility. With a primary focus on understanding these barriers, my aim is to progress towards devising strategies and implementing them effectively.

Currently, my team and I are delving into the concept of self-collection for HPV testing in Rwanda. This method has gained prominence, particularly in British Columbia, primarily because of its heightened sensitivity compared to traditional Pap smears in cervical cancer screening. Our research will involve integrating this more sensitive and efficient approach, which allows individuals to self-collect samples, into Rwanda’s healthcare infrastructure.

Looking ahead, I hope that I can continue working on the integration of HPV DNA testing and self-collection methods in Rwanda. By doing so, I hope to shed light on how these innovations can significantly enhance access to and rates of cervical cancer screening in the region.