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Capacity building for pediatric neuro-oncology in Pakistan- a project by my child matters program of Foundation S
Naureen Mushtaq1, Bilal Mazhar Qureshi2, Gohar Javed3
1Peadiatric Oncology Section, Department of Oncology, Aga Khan University, Karachi, Pakistan.
Insights
This project enhanced pediatric neuro-oncology care in Pakistan by establishing national multidisciplinary tumor boards and training specialists. The initiative improved treatment protocols and increased the number of pediatric neuro-oncologists, benefiting a large population.
Area of Science:
- Oncology
- Public Health
- Medical Education
Background:
- Limited pediatric neuro-oncology (PNO) capacity in low-middle income countries.
- Need for standardized treatment protocols and multidisciplinary care for childhood brain tumors.
- Challenges in healthcare collaboration and education due to geographical and resource constraints.
Purpose of the Study:
- To enhance pediatric neuro-oncology (PNO) care capacity in Pakistan through a collaborative national initiative.
- To establish and operate national Multidisciplinary Tumor Boards (MTBs) for improved diagnosis and treatment planning.
- To develop standardized PNO treatment protocols and foster specialized training programs.
Main Methods:
- Established 15 hospital-based Multidisciplinary Tumor Boards (MTBs) covering 76% of Pakistan's population.
- Transitioned MTBs to videoconferencing during the COVID-19 pandemic, conducting 124 meetings and discussing 545 cases.
- Implemented virtual educational initiatives, including over 40 lectures and two symposia, for healthcare professionals.
Main Results:
- Developed standardized national treatment protocols for low-grade glioma, medulloblastoma, and high-grade glioma.
- Launched Pakistan's first PNO fellowship program, increasing the number of trained specialists to three.
- Successfully adapted to virtual platforms for continued collaboration and education amidst the pandemic.
Conclusions:
- The initiative demonstrates successful capacity building in PNO within a low-middle income country through intra-national collaboration.
- Established treatment protocols, fellowship programs, and regional tumor boards show potential for sustainable improvements in PNO care.
- Ongoing efforts to establish a national PNO case registry will further enhance care management and monitoring.
Introduction:
Initiated in June 2019, this collaborative effort involved 15 public and private sector hospitals in Pakistan. The primary objective was to enhance the capacity for pediatric neuro-oncology (PNO) care, supported by a My Child Matters/Foundation S grant.
Methods:
We aimed to establish and operate Multidisciplinary Tumor Boards (MTBs) on a national scale, covering 76% of the population (185.7 million people). In response to the COVID-19 pandemic, MTBs transitioned to videoconferencing. Fifteen hospitals with essential infrastructure participated, holding monthly sessions addressing diagnostic and treatment challenges. Patient cases were anonymized for confidentiality. Educational initiatives, originally planned as in-person events, shifted to a virtual format, enabling continued implementation and collaboration despite pandemic constraints.
Results:
A total of 124 meetings were conducted, addressing 545 cases. To augment knowledge, awareness, and expertise, over 40 longitudinal lectures were organized for healthcare professionals engaged in PNO care. Additionally, two symposia with international collaborators and keynote speakers were also held to raise national awareness. The project achieved significant milestones, including the development of standardized national treatment protocols for low-grade glioma, medulloblastoma, and high-grade glioma. Further protocols are currently under development. Notably, Pakistan's first pediatric neuro-oncology fellowship program was launched, producing two graduates and increasing the number of trained pediatric neuro-oncologists in the country to three.
Discussion:
The initiative exemplifies the potential for capacity building in PNO within low-middle income countries. Success is attributed to intra-national twinning programs, emphasizing collaborative efforts. Efforts are underway to establish a national case registry for PNO, ensuring a comprehensive and organized approach to monitoring and managing cases. This collaborative initiative, supported by the My Child Matters/Foundation S grant, showcases the success of capacity building in pediatric neuro-oncology in low-middle income countries. The establishment of treatment protocols, fellowship programs, and regional tumor boards highlights the potential for sustainable improvements in PNO care.
