For 21 years I have been living with endometriosis, which occurs when tissue similar to the lining of the uterus grows outside the uterus, causing debilitating pain and/or infertility. It takes on average 7 to 10 years to be diagnosed, yet I was misdiagnosed for 11 years. In 1989, when I started seeking an explanation for my excruciating pain, there was no laparoscopy available in Ghana. Laparoscopy is the best way to diagnose endometriosis, although it’s rarely available and costs between $1700 - $5000. The delays resulted in my Stage IV diagnosis, which finally occurred after I was rushed to A&E while visiting my family in London.

My endometriosis journey within the Ghanaian health system has been very expensive, as endometriosis care is not covered by medical insurance. My monthly treatment costs are on average $350 - $500. To afford this, I have had to secure loans, both for managing the condition and also for the eight surgeries I have undergone. Each surgery costs on average $2,500 - $4000. There is a significant ignorance and misconception about NCDs, and endometriosis is barely recognized because menstrual pain is tagged as normal; thus there is a lack of financial support from the government.

My advocacy has connected me to a lot of 'endo warriors' and has inspired women to come out and seek help. A key challenge faced by this community is the lack of affordability of diagnostic services, as the cost of laparoscopy is high and not offered through national health insurance. Countless women I have met rely on pain killers, as they cannot afford diagnosis. Although a scan is less expensive than a laparoscopy, it is not as accurate and is still too expensive for many people that are not covered by health insurance.

Since joining Ghana NCD Alliance, I’ve learned the importance of uniting over common goals, as treatment and management are also very difficult for other people living with NCDs. The chronic nature of NCDs and the costs associated with long-term care can result in catastrophic health expenditure, pushing households deep into poverty. I met a gentleman living with diabetes, who refused the NHIS since his medications are not on the exemption list, and laboratory tests must be paid out-of-pocket. An elderly woman who suffered a stroke shares the same issues and is also unable to afford healthy foods, which makes her condition worse. We demand action from decision‑makers to address these critical challenges.

I call on the Ministries of Education, Gender and Health and on the government of Ghana to:

• Launch public awareness campaigns in schools and communities to combat NCD stigma.
• Implement robust financing structures to move towards UHC. When people have to pay most of their health service ;costs out of their own pockets, the poor are often unable to obtain many of the services they need.

We hope for a future without delayed diagnosis, high treatments costs, and lack of treatment options. Ghana needs proper integration of all NCDs into UHC.