Addressing regional disparities in pediatric oncology: Results of a collaborative initiative across the Mexican–North American border

Abstract

Background Cancer is emerging as a major cause of childhood mortality in low-income and middle-income countries. In Mexico, cancer is the number one cause of death in children aged 5–14. Until recently, many children with cancer from Baja California, Mexico went untreated. We reasoned that an initiative inspired by the St. Jude Children’s Research Hospital (SJCRH) “twinning” model could successfully be applied to the San Diego–Tijuana border region. In 2008, a twinning project was initiated by Rady Children’s Hospital, SJCRH and the General Hospital Tijuana (GHT). Our aim was to establish a pediatric oncology unit in a culturally sensitive manner, adapted to the local health care system. Procedure An initial assessment revealed that despite existence of basic hospital infrastructure at the GHT, the essential elements of a pediatric cancer unit were lacking, including dedicated space, trained staff, and uniform treatment. A 5-year action plan was designed to offer training, support the staff financially, and improve the infrastructure. Results After seven years, accomplishments include the opening of a new inpatient unit with updated technology, fully-trained staff and a dedicated, interdisciplinary team. Over 700 children have benefited from accurate diagnosis and treatment. Conclusions Initiatives that implement long-term partnerships between institutions along the Mexican-North American border can be highly effective in establishing successful pediatric cancer control programs. The geographic proximity facilitated accelerated training and close monitoring of project development. Similar initiatives across other disciplines may benefit additional patients and synergize with pediatric oncology programs to reduce health disparities in underserved areas.

Impact of the COVID‐19 pandemic on pediatric oncology providers globally: A mixed‐methods study

“…Before the pandemic, the global pediatric oncology workforce faced many challenges, including staff shortages, 25 occupational safety concerns, and burnout. [12][13][14]26,27 This study highlights additional obstacles faced by providers during the COVID-19 pandemic, including modifications to staffing and physical, psychological, and financial impacts. Despite these barriers, HCPs caring for children with cancer across the world were shown to be incredibly resilient, coming together to continue to provide care even in the direst circumstances.…”

Acute Lymphoblastic Leukaemia Survival in Children Covered by Seguro Popular in Mexico: A National Comprehensive Analysis 2005–2017

“…The top two Mexican hospitals (based on 5-year overall survival) in our analysis are engaged in long-term twinning partnerships with United States institutions (Supplementary Table 7). 28,29 In countries like Mexico, where some pediatric care facilities provide quality of care comparable to high-income countries, similar within-country twinning partnerships could be established.…”

Identifying barriers to treatment of childhood rhabdomyosarcoma in resource‐limited settings: A literature review

“…Ongoing efforts by the global academic and medical communities to advocate for national pediatric cancer registries and pediatric cancer national healthcare plans, and to improve available infrastructure and care delivery through twinning models, planning of healthcare delivery networks, and cooperative national and regional groups, are all mechanisms by which patient outcome may be improved for children with RMS and other childhood cancers requiring complex multidisciplinary care. The successes reported in several centers in UMIC and LMIC, especially with involvement of NGOs for proper resource allocation and infrastructure development, serve as a model for refinement of pediatric cancer care in areas with limited resources.…”