After Akuetteh entered the U.S. Foreign Service in 1984, she held a series of international assignments in Niger, Tanzania, Canada and Venezuela.

[4] In 2012 she headed the U.S. delegation to a meeting of the US – Nigeria Bi-national Commission on the Niger Delta and National Development Working Group held in Port Harcourt.

[5] She appeared before the Senate Foreign Relations Committee December 17, 2013 to discuss her vision for her role as ambassador.

[6][7] At a time of political unrest in Gabon, she publicly expressed concern over any "extra-constitutional" moves for regime change and promoted "democratic" solutions.

Akuetteh noted that the prime purpose of the undertaking was to maintain peace and strengthen the relationships of the countries participating.