Eswatini, one of the countries with the highest cervical cancer burden globally, is making significant strides toward eliminating the disease through its Cervical Cancer Elimination Acceleration Plan (2024–2028). Supported by the World Health Organization (WHO) Country Office, the plan aligns with the WHO Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem and aims to achieve the 90–70–90 targets by 2030. As part of this effort, the Ministry of Health has introduced a task-sharing approach that empowers nurses to perform Loop Electrosurgical Excision Procedure (LEEP) treatments under the mentorship of doctors, while HPV testing and Visual Inspection with Acetic Acid (VIA) services have been decentralized to primary healthcare facilities and laboratories.
On 24 October 2025, the WHO Country Office in Eswatini, in collaboration with the Ministry of Health and with technical support from the WHO Regional Office for Africa, launched a 10-day LEEP training program for healthcare workers. Held from 6 to 17 October 2025, the program focused on strengthening national capacity for the treatment of cervical precancerous lesions in line with WHO’s global elimination strategy. The training combined theoretical instruction and hands-on clinical practice, equipping participants with enhanced technical expertise, decision-making skills, and adherence to WHO standards in infection prevention, patient safety, and treatment integration within primary healthcare settings.
Co-organized by the WHO and the National Cancer Control Unit, the training brought together 31 healthcare workers—including eight doctors and 23 nurses—who participated in both classroom and supervised clinical sessions across three sites: Phocweni Clinic, AHF Clinic, and Chakaza Clinic. Participants received training in anatomy, screening techniques (VIA/VILI), pre-cancer treatment procedures (thermal ablation and LEEP), infection prevention and control, pathology, and data management. Over 80 procedures were successfully performed during the sessions, including 33 LEEPs, one thermal ablation, and three biopsies, significantly reducing the backlog of cases awaiting treatment.
The program led to notable improvements in clinical decision-making, treatment eligibility assessments, and referral practices. Coordination and communication between screening, treatment, and pathology services were also enhanced, ensuring a more efficient continuum of care. The training further highlighted the importance of establishing a National Cervical Cancer Task Force and updating national screening and treatment guidelines to align with WHO recommendations, key steps toward sustaining long-term progress.
This initiative marks a milestone in advancing the third pillar of Eswatini’s cervical cancer elimination strategy. By focusing on healthcare workforce capacity building, the country has demonstrated how targeted, evidence-based interventions can improve service delivery and accelerate progress toward elimination, even in high-burden settings. Going forward, trained participants are expected to complete 30 additional LEEP procedures for certification by March 2026, integrate data into the DHIS2 system, and contribute to mentorship and quality assurance frameworks.
The WHO-facilitated LEEP training in Eswatini exemplifies the impact of strong collaboration between national authorities and international partners. It reflects how commitment, technical excellence, and evidence-based action can turn global strategies into tangible outcomes—moving Eswatini closer to the goal of eliminating cervical cancer as a public health problem.
