Building capacity, changing lives: The transformative power of Gynecologic Oncology Fellowship Training in Kenya

Gynecologic Oncology Fellowship Training in Kenya

Abstract

In 2019, the University of Nairobi (UoN) launched a gynecologic oncology fellowship program within the Department of Obstetrics and Gynecology, marking a pivotal milestone in Kenya's efforts to improve the availability and accessibility of equitable cancer care. At that time, only 8 trained gynecologic oncologists served a population exceeding 50 million in a setting where reproductive tract cancers remain highly prevalent (1). Breast, cervical, esophageal, colorectal, and ovarian cancers constitute the leading cancer burden among women, with 3 of the top 5 women malignancies affecting the female reproductive system. Advanced-stage disease accounts for 70% to 80% of gynecologic cancer diagnoses (2). This burden is driven by delayed presentation, limited diagnostic and treatment infrastructure, and a critical shortage of specialized personnel, particularly gynecologic oncologists. The fellowship program was established as a strategic response to strengthen specialized cancer care in Kenya and the broader region.

By December 2024, 15 fellows had graduated, with an additional 10 expected to complete training by August 2025. This progress reflects strong collaboration between UoN and its teaching hospital, Kenyatta National Hospital (KNH), the largest referral facility and gynecologic oncology unit in Kenya and the region. This partnership integrates clinical expertise with academic training.

The fellowship’s impact aligns with national and global health priorities. It supports Kenya’s Cancer Policy 2019-2030 (3), the National Cancer Control Strategy (2023–2027) (4), and Vision 2030 (5), all of which prioritize prevention, early detection, universal access to care, and health workforce development. The devolution of health services in 2013 further highlighted the need to build specialist capacity at the county level. While specialists were historically concentrated in urban referral hospitals, in contrast, this fellowship recruits trainees from across Kenya and the region, with the goal of decentralizing gynecologic oncology services to underserved populations.

This supplement highlights these achievements by presenting the scholarly contributions of fellows, demonstrating the program’s role in developing both clinical and academic expertise. The included manuscripts examine outcomes of neoadjuvant chemotherapy and concurrent chemoradiation in locally advanced cervical cancer, human papillomavirus (HPV) vaccine uptake among schoolgirls in Migori, retrospective analyses of uterine sarcomas, recurrence patterns of early-stage cervical cancer, high-risk HPV burden in incarcerated women, surgical outcomes and complications in vulvar cancer, and real-world implementation of lesion ablation among women living with HIV.

Collectively, these studies reflect a growing culture of research and data-driven practice. They emphasize patient-centered, system-informed care and align with the World Health Organization’s call for integrated cancer control that is both contextually relevant and sustainable.

The consistent theme across all contributions is that local challenges require local solutions. For too long, Kenya and much of sub-Saharan Africa has been characterized as “data rich but information poor.” This fellowship program is helping to shift that paradigm by transforming routinely collected program data into actionable evidence to inform clinical practice and policy.