Team PACT: Increasing the accessibility of cervical cancer screenings in Ghana

Although cervical cancer is one of the leading causes of cancer-related deaths for Ghanaian women, fewer than 5% of eligible individuals in Ghana have ever been screened for cervical cancer. Additionally, since HPV is known to cause over 95% of all diagnosed cervical cancers, HPV detection for Ghanaian women is incredibly important, yet inaccessible for many.  

In their work, Team PACT, a student-led project team at M-HEAL, addresses the barriers that prevent Ghanaian women from obtaining this care. Ultimately, their goal is to increase screening rates and improve health outcomes in Ghana through cancer prevention methods that can later be expanded to other Low- and Middle-Income Countries (LMIC). 

Team PACT’s Project Lead, Eitan Frankowitz, explains his team’s desire to join FUSED, saying, “This was all entirely new territory for us, especially because a lot of the work on our team has been done, but not in rural Ghana. We were starting off with a jumble of ideas and different directions that this could go, and so we thought that FUSED could help us.” 

Intrigued by the potential of FUSED, Eitan Frankowitz, Arya Gandhi, Kyle Crockett, Aidan Connolly,  and Evelyn Antony, became the Core Five representatives of Team PACT during FUSED’s inaugural pilot year. 

Now, after a year of completing modules, brainstorming in meetings, and navigating challenging design questions, Team PACT is more prepared than ever to continue their important and exciting work. 

 

 

Part I: A fork in the road 

Just before joining the FUSED program, Team PACT was in the process of expanding their connection with the Korle Bu Teaching Hospital (KBTH) in Ghana. An integral stakeholder, KBTH would be able to serve as a vector for conducting preliminary testing and providing feedback on PACT’s screening device. 

This reusable device uses urine-based methods with PCR (polymerase chain reaction) assays to provide a non-invasive method of accurately detecting HPV in the cervix.

Because certain HPV proteins are hallmarks for precancerous and cancerous lesion development, HPV testing often plays a significant role in detecting cancer risk.  

Through conversations with their healthcare partners in Ghana, the team learned that their original device was not as sanitary or accessible as they had initially thought. In response, they began to consider an at-home testing or point-of-care model instead. This pivot would also allow for the expansion of screening capabilities into the rural areas of Ghana. 

After conducting interviews with healthcare providers and patients during their preliminary testing, Team PACT also realized that they needed to further explore the motivations and needs of their stakeholders in rural and suburban areas. 

With their preliminary testing through Ghana’s Food and Drug Authority completed and approved,  Team PACT wanted to deepen their understanding of the situation as a whole. 

 

Part II: Embracing FUSED’s resources

As they entered the program, Team PACT turned to the socially engaged design process model in the effort to leave no stone unturned. From completing the modules, meeting with mentors, or ideating within the team, PACT was motivated to take full advantage of every opportunity. 

Making the most of the modules 

One of the main resources that FUSED offers is its curated modules. Choosing from a list of options, each team selects modules that are directly relevant to their particular challenge. 

In the “Interviewing Skills” module, PACT considered how they would speak to stakeholders, what questions they would ask, and what they hoped to learn from community partners when they travel to Ghana next. 

“Problem Definition” encouraged PACT to synthesize previous interviews and relevant literature in order to develop and clarify their problem statement. 

During “Preparing for a Needs Assessment,” PACT prepared to travel for the first time to Ghana as a team by identifying the gaps in their current understanding and planning ahead for any potential problems.

Through the “Determining Requirements + Specifications” module, Team PACT evaluated the design inputs for their point-of-care device, identified relevant stakeholders that had not been previously considered, and drafted user requirements and specifications.

Clarifying their design 

Ultimately, Team PACT decided to pursue a point-of-care device that would allow women to test at home. 

Part of this decision entailed pivoting away from their previous design. Fitted for a Western-style toilet, their original device relies primarily on PCR testing and is limited by cost and logistical challenges. 

Instead, Team PACT will use microfluidic technologies as their primary screening method, allowing for a greater breadth of the markers that indicate cervical cancer development. 

This new design would offer an alternative to the costly,  invasive, and limited screening methods that are currently available in suburban and rural areas, allowing PACT to reach more individuals. 

 

Acknowledging overlooked areas or incomplete assumptions

With the assistance of FUSED as well as Dr. Dhanu Thiyag, an OB/GYN Mentor at U-M, Team PACT was able to connect with Dr. Sasha Hernandez – an OB/GYN at NYU who does educational work concerning women’s health in Ghana. 

Dr. Hernandez became a deeply influential resource in PACT’s process, as their conversations revealed where PACT’s assumptions or oversights were holding them back.

From their discussions with Dr. Hernandez, PACT made the important realization that a husband’s comfort level with the screening device is just as important, if not more so, when considering whether or not a woman receives a screening. 

Eitan Frankowitz expands on this important realization, saying, “We were not planning to interview the men on women’s health because we didn’t think that it pertains to them, but Dr. Hernandez helped us to understand that it is almost more important than what the woman’s perception is because he will determine whether she pays for it or not and whether it’s an important thing for him.” 

Continuing to evaluate the stakeholders that they had previously overlooked, Team PACT realized that they also needed to consider the government’s role more seriously in their rollout process.

“If you don’t include all these other organizations and all these other individuals who do have a stake in the project, then you are leaving room for the project to eventually be shot down because it can’t pass certain government regulations, or you’re just not including individuals that matter,” explains Frankowitz. 

By acknowledging all of their stakeholders, Team PACT has a greater chance of realistically affecting screening rates in Ghana. 

Expanding education

Finally, FUSED helped Team PACT recognize the value of education in the potential acceptance and rollout of their device. 

Now, they have established an educational component that is dedicated to increasing understanding of how the device works as well as the importance of screenings when it comes to preventing infections. 

By addressing the barrier that the lack of education or understanding presents, Team PACT continues to move towards improving women’s health in Ghana, from the little steps to big picture ideation. 

Part III: Looking forward 

By the time they reached the final Wrap-Event for FUSED’s inaugural year, Team PACT appeared to have the momentum they originally sought when they came to FUSED. Not only has PACT begun working with U-M’s Burns Lab to use their microfluidic cartridges paired with Hemex Health’s Gazelle platform, but they are also developing plans for a research trip to Ghana in December 2025.  

The hard work of these Core Five students, along with the rest of their M-HEAL team, was and continues to be greatly admired by their collaborators at the Center for Socially Engaged Design.

As they pursue their ultimate goal of increasing the accessibility of cervical cancer screenings in Ghana, Team PACT will always have the support of their FUSED Program collaborators.  

You can learn more about Team PACT through their LinkedIn page or by emailing team-pact@umich.edu.