Pediatric Cancer Recognition Training in Botswana

Abstract

Delayed presentation of children with cancer is a significant barrier to improving the survival from children’s cancer in low- and middle-income countries (LMICs). Botswana, a country of approximately 2 million people in southern Africa, has only 1 pediatric cancer treatment program, based at Princess Marina Hospital (PMH) in the capital of Gaborone. A pediatric cancer recognition training program was developed that reached 50% of the government hospitals in Botswana teaching 362 health care workers how to recognize and refer children with cancer to PMH. Through evaluation of attendees, limitations in pediatric cancer training and general knowledge of pediatric cancer were identified. Attendees demonstrated improvement in their understanding of pediatric cancer and the referral process to PMH following the workshop.

The outcome and cost of a capacity‐building training programme on the early recognition and referral of childhood cancer for healthcare workers in North‐West Cameroon

“…This is not unexpected, given a doctor‐to‐population ratio of 0.08 per 1,000 (Central Intelligence Agency, 2018) compared with a nurse‐to‐population ratio of 0.8 per thousand (Global Health Workforce Alliance, 2020lliance, 2020) and the fact that, as reported in 2013 (World Bank, 2013), 40% of the country's doctors practice in the central region, where the capital city Yaounde is located. Most health professionals who attended the training were nurses, similar to the case in Botswana, although the ratio of nurse to physician in that setting was much smaller (1.6:1) than in this report (14:1) (Slone et al., 2016b). This highlights the importance of including nurses in capacity‐building training programmes in Africa to promote the early identification and prompt referral of childhood cancer patients.…”

“…The Botswana training programme reported an average cost of $11.20 per participant (Slone et al, 2016a), while the cost for this project in Cameroon was €25.06 ($ 27.64) per healthcare provider.…”

“…This highlights the importance of including nurses in capacity-building training programmes in Africa to promote the early identification and prompt referral of childhood cancer patients. Noteworthy is the fact that TA B L E 1 Characteristics of participants The Saint Siluan signs have also been used in South Africa (Poyiadjis et al, 2011) and in Botswana (Slone et al, 2016a) for educating healthcare providers on childhood cancer. Providing nurses with educational material has been shown to be effective in enhancing knowledge acquired from special training (David & Banerjee, 2010).…”

Factors influencing diagnostic delays of pediatric cancers in Botswana

“…In South Africa, an educational campaign focused on the cancer warning signs directed toward primary health workers and the public increased the number of new patient referrals significantly in the six years following the campaign; however, there was not a significant impact on referring patients at an earlier stage in their disease . To address the late presentation of pediatric cancer patients in Botswana, the Global HOPE Botswana program led pediatric cancer recognition workshops at 14 district hospitals (50% of government/mission hospitals) with a total of 362 healthcare workers trained in 2014 to 2015, while this study was ongoing; thus, we cannot evaluate the impact of this program based on this cohort's data . A follow‐up program was launched in 2019 to expand training to 75% of government/mission district hospitals using tools for recognition of the signs and symptoms of pediatric cancer developed by international agencies.…”

Establishing a Pediatric Hematology-Oncology Program in Botswana

“…To improve pediatric cancer recognition and diagnosis in Botswana, more than 350 health care providers at half of the government/mission hospitals were recently trained about presenting signs and symptoms of cancer in children and how to refer these children to PMH. 19 …”