Peer-reviewed article
Establishing a national shared care network for paediatric oncology in Cameroon: Development process, baseline findings and early lessons.
Afungchwi GM, Pondy-Ongotsoyi A, Waindim Y, Kakanou FZ, Ward N et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001Cameroon established a national Shared Care Network for childhood cancer in 2023 to improve access to treatment, which has historically had survival rates below 30% in sub-Saharan Africa. The network designates two hub hospitals with full oncology services and eight shared-care centres that provide basic treatment with referral links. A baseline assessment found significant gaps, including no radiotherapy or immunohistochemistry capacity and psychosocial services in only three centres. The development process created a validated framework with defined roles, referral pathways, and training priorities to guide implementation.
Key points
- Childhood cancer survival in sub-Saharan Africa remains below 30%, largely due to delayed diagnosis, weak referral systems, and limited specialised services
- Two hub centres (Mbingo Baptist Hospital and Mother and Child Centre, Chantal Biya Foundation) designated with full oncology services; eight shared-care centres provide basic chemotherapy and diagnostics
- Only 49 healthcare workers identified across ten hospitals, including five paediatric oncologists and thirty-five trained nurses
- Critical gaps in diagnostic and treatment capacity: no immunohistochemistry or radiotherapy available at any centre; CT scans and paediatric surgery only at hubs
- Psychosocial and rehabilitative services available in only three centres; civil society groups provide essential support in transport, accommodation, and drug procurement
Limitations
This is a baseline assessment and early description of network establishment; it does not yet measure outcomes such as improved survival rates, reduced treatment delays, or patient access. The document describes infrastructure and capacity at a single point in time and does not provide longitudinal data on network effectiveness or sustainability.
Abstract
Background Childhood cancer survival in sub-Saharan Africa remains below 30%, largely due to delayed diagnosis, weak referral systems, and limited specialised services. To improve access and continuity of care, Cameroon launched a national Shared Care Network (SCN) for paediatric oncology in 2023 under the WHO Global Initiative for Childhood Cancer and within the CureAll framework. This study aimed to describe the development process, baseline findings, network design, and early lessons from establishing Cameroon's national paediatric oncology Shared Care Network. Methods A baseline assessment using the International Society of Paediatric Oncology (SIOP) Global Mapping Survey was conducted in ten hospitals across six regions. Data were collected on oncology infrastructure, staffing, diagnostic and treatment capacity, and access to supportive services. Centres were classified according to service level, and findings were validated through stakeholder workshops involving the Ministry of Public Health, the National Committee for the Fight Against Cancer (NaCFAC), and partner organisations. These findings informed centre classification, referral pathway design, service package definition, workforce training priorities, and development of a national SCN implementation manual. Results Two hospitals: Mbingo Baptist Hospital and the Mother and Child Centre, Chantal Biya Foundation were designated as hub centres with full oncology services. Eight others function as shared-care centres, providing basic chemotherapy and diagnostics with referral links to the hubs. All facilities had access to X-ray and ultrasound, while CT scans and paediatric surgery were available only at the hubs. None had immunohistochemistry or radiotherapy. Forty-nine healthcare workers were identified, including five paediatric oncologists and thirty-five trained nurses. Psychosocial and rehabilitative services were available in only three centres. Civil society groups provided key support in transport, accommodation, and drug procurement. The development process produced a nationally validated SCN framework with defined hub and shared-care roles, referral pathways, service packages, and training priorities. Conclusion The establishment of Cameroon's SCN demonstrates the feasibility of developing a coordinated and decentralised paediatric oncology network within an existing health system in a resource-limited setting. Integrating the SCN into national policy, investing in diagnostics, and institutionalising training will be essential for sustainability and scaling toward universal coverage and improved childhood cancer survival in Cameroon.