Enhancing Childhood Cancer Care In African Low-Middle Income Countries: A Tunisian Pilot Experience

Abstract

<h3>Objectives</h3> Paediatric radiotherapy in African countries faces many challenges mainly due to socio-economic issues and scarcity of dedicated paediatric radiation oncologists. The IAEA is promoting paediatric radiation oncology through short fellowships programs within the framework of RAF6055 project. The Tunisian pilot experience integrated these fellows from French speaking countries into a 6-week Masterclass dedicated to paediatric radiotherapy. The program aimed to promote effective collaboration between African LMIC to improve the quality of paediatric radiotherapy practices. <h3>Methods</h3> Sessionswere organized by the Radiation Oncology Department of Abderrahmen Mami Teaching Hospital, under the auspices of the Tunisian Society of Radiation Oncology (STOR) and Faculty of Medicine of Tunis. Participants included Tunisian residents, African radiation oncologists involved in childhood cancer care, medical physicists and RTT's. The training program course materiel and practicum covered indications, techniques of irradiation and contouring workshops in most frequent childhood cancers. Courses were given by international and national experts in paediatric radiotherapy. Sessions were live-streamed in order to widen the knowledge access. Weekly contouring workshops were organized using an online platform (Proknow Elekta®) and aimed to learn the guidelines and best practices proposed by the experts and further integrate them into daily practice. A thirty-item survey was distributed to participants to evaluate the program's efficiency and impact on their clinical practice. <h3>Results</h3> A total of 35 participants attended the training program mainly from north and west Africa. Clinical areas covered by the program were considered relevant to learning objectives by 86.7% of participants. Overall organisation, including course quality, allocated time, dedicated technical material and expert's availability, was satisfying according to 93.3% of attendees. All participants reported a substantial benefit of the training program in term of updating knowledge and improving technical skills in paediatric radiotherapy. <h3>Conclusion</h3> Strengthening collaboration between African countries through targeted training programs is an accessible cost-effective strategy to improve childhood cancer care. Every effort should be made to promote these programs and support the role of existing paediatric radiation oncologists in these regions.