Training pediatric hematologist/oncologists for capacity building in Ethiopia

Hailu, Daniel; Hordofa, Diriba Fufu; Endalew, H.A.; Mutua, Doreen Karimi; Bekele, Wondwessen; Bonilla, Miguel; Celiker, Mahmut; Challinor, Julia; Dotan, Amit; Habashy, Catherine; Kumar, Prashanth Ashok; Rodríguez‐Galindo, Carlos; Wali, Rabia; Weitzman, Sheila; Broas, Julie; Korones, David N.; Alexander, Thomas; Shad, Aziza

doi:10.1002/pbc.28760

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…Yet, an estimated 80% of children with cancer in Ethiopia are still not being diagnosed or referred to a pediatric hematology-oncology treatment center. 19 There is no cancer registry in the country, making it difficult to inform health resource planning for cancer management.…”

Section: Introductionmentioning

confidence: 99%

Health Services Needs Assessment for Retinoblastoma in Ethiopia

Sherief

O’Banion

et al. 2023

JCO Global Oncology

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PURPOSE The aim of this study was to document the available resources and needs for the detection, diagnosis, and treatment of retinoblastoma (RB) in Ethiopia. METHODS A health services needs assessment focused on RB care in Ethiopia was conducted. Information was obtained through a web-based survey and field visits. Facilities offering RB service delivery were categorized into three tiers, on the basis of the ability to detect (tier 1) and manage simple (tier 2) or complex (tier 3) patients with RB. Descriptive statistics were performed to quantify human and material resources available at each facility. RESULTS The web survey received 29 responses from ophthalmologists at 19 health care facilities. Of the 19 units surveyed, seven (36.8%) had an ophthalmologist dedicated to RB treatment, classifying them as either a tier 2 or 3 facility. All tier 3 facilities had an affiliated health facility offering access to off-site pediatric oncology and pathology services. Of the focal therapies offered at tier 3 facilities, none included local chemotherapy or brachytherapy. Enucleation was offered at all tier 2 facilities, but availability of orbital implants and ocular prostheses was variable. None of the health facilities offered genetics services. CONCLUSION This study demonstrated that the human and material resources needed for RB care in Ethiopia are constrained. Tier 3 RB facilities are rare and concentrated in urban areas, which could make it difficult for many patients to access. With focused capacity-building efforts, it is possible to increase the efficiency of RB therapy.

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Section: Introductionmentioning

confidence: 99%

Health Services Needs Assessment for Retinoblastoma in Ethiopia

Sherief

O’Banion

et al. 2023

JCO Global Oncology

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“…The JUMC POU was started as part of the development of a comprehensive pediatric cancer program led by Aslan. As previously described, the approach focused on training subspecialty physicians in the Ethiopian setting, rather than external fellowship programs, although each trainee also spent a six month period in a POU outside of Ethiopia with the majority going to a teaching hospital in India [ 10 ]. In addition, prior to COVID-19, regular visits to Ethiopia POUs were made by pediatric hematologist/oncologists under the auspices of Aslan.…”

Section: Resultsmentioning

confidence: 99%

Childhood cancer presentation and initial outcomes in Ethiopia: Findings from a recently opened pediatric oncology unit

Hordofa,

Ahmed,

Birhanu

et al. 2024

PLOS Glob Public Health

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There were no pediatric oncology centers in southwest Ethiopia prior to 2016. This study aims to describe presenting diagnoses and initial outcomes at Jimma University Medical Center (JUMC), the first pediatric oncology unit (POU) in southwest Ethiopia, provide initial insights into regional pediatric cancer epidemiology, illustrate the rapid growth of pediatric cancer services, and highlight ongoing challenges. We used a retrospective descriptive approach to assess the epidemiologic pattern and initial treatment outcomes of pediatric cancer at JUMC POU from August 2016 through December 2022. During the study period, 749 children were diagnosed with cancer at JUMC. The mean age was 7.2 years (20 days—18 years). Acute lymphoblastic leukemia was the most common diagnosis (16.4%), followed by non-Hodgkin lymphoma (12.4%), Wilms tumor (11.1%), soft tissue sarcoma (8.8%), Hodgkin lymphoma (8.4%), and retinoblastoma (8.3%). Brain tumors accounted for only 2.7% of the diagnoses. Of the 703 patients that were not referred elsewhere, 42% of the patients abandoned treatment, 29% died, 17% completed treatment, and 7% remained on treatment at the time of this assessment. The findings emphasize the growth in the diagnosis and treatment of children with cancer in the southwest region of Ethiopia. The data suggests a different epidemiologic profile of childhood cancer cases diagnosed at the JUMC POU compared to high-income countries and neighbouring countries in Africa. Treatment abandonment remains a barrier to care. Ongoing areas of focus include establishment of a hospital-based cancer registry, reduction of treatment abandonment, improvement of diagnostic capacity, and increased access to advanced supportive care.

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“…Domain analyses included factors considered in accreditation standards, elements in published conceptual models for graduate medical education standards, and components of evaluation tools developed for other medical specialties 8,16–28 . In addition, questions included theoretical content that was mapped to the specifications of pediatric hematology/oncology care 29–32 …”

Section: Methodsmentioning

confidence: 99%

“…8,[16][17][18][19][20][21][22][23][24][25][26][27][28] In addition, questions included theoretical content that was mapped to the specifications of pediatric hematology/oncology care. [29][30][31][32] To make EPAT quantitative, each item was assigned a score, the value of which reflected the item's relative importance to the domain.…”

Section: Operationalizationmentioning

confidence: 99%

Development of EPAT: An assessment tool for pediatric hematology/oncology training programs

Moreira

Metzger

Antillón‐Klussmann

et al. 2023

Cancer

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PurposeIn the absence of a standardized tool to assess the quality of pediatric hematology/oncology training programs, the Education Program Assessment Tool (EPAT) was conceptualized as a user‐friendly and adaptable tool to evaluate and identify areas of opportunity, pinpoint needed modifications, and monitor progress for training programs around the world.MethodsThe development of EPAT consisted of three main phases: operationalization, consensus, and piloting. After each phase, the tool was iteratively modified based on feedback to improve its relevance, usability, and clarity.ResultsThe operationalization process led to the development of 10 domains with associated assessment questions. The two‐step consensus phase included an internal consensus phase to validate the domains and a subsequent external consensus phase to refine the domains and overall function of the tool. EPAT domains for programmatic evaluation are hospital infrastructure, patient care, education infrastructure, program basics, clinical exposure, theory, research, evaluation, educational culture, and graduate impact. EPAT was piloted in five training programs in five countries, representing diverse medical training and patient care contexts for proper validation of the tool. Face validity was confirmed by a correlation between the perceived and calculated scores for each domain (r = 0.78, p < .0001).ConclusionsEPAT was developed following a systematic approach, ultimately leading to a relevant tool to evaluate the different core elements of pediatric hematology/oncology training programs across the world. With EPAT, programs will have a tool to quantitatively evaluate their training, allowing for benchmarking with centers at the local, regional, and international level.

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Training pediatric hematologist/oncologists for capacity building in Ethiopia

Cited by 6 publications

References 27 publications

Health Services Needs Assessment for Retinoblastoma in Ethiopia

Health Services Needs Assessment for Retinoblastoma in Ethiopia

Childhood cancer presentation and initial outcomes in Ethiopia: Findings from a recently opened pediatric oncology unit

Development of EPAT: An assessment tool for pediatric hematology/oncology training programs

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