Capacity building for pediatric neuro-oncology in Pakistan- a project by my child matters program of Foundation S
Authors: Mushtaq Naureen , Qureshi Bilal Mazhar , Javed Gohar , Sheikh Nabeel Ashfaque , Bakhshi Saqib Kamran , Laghari Altaf Ali , Enam Syed Ather , Anwar Shayan Sirat Maheen , Hilal Kiran , Kabir Arsalan , Ahmad Alia , Goraya Amber , Mistry Anum Salman , Rashid Aqeela , Maaz Ata Ur Rehman , Munawar Muhammad Atif , Khan Atiq Ahmed , Bashir Farrah , Hashmi Hina , Saeed Kamran , Khandwala Kumail , Rehman Lal , Dewan Michael C. , Khan Muhammad Saghir , Karim Muneeb uddin , Shaheen Najma , Zia Nida , Yasmeen Nuzhat , Mahmood Raheela , Memon Riaz Ahmed Raja , Kirmani Salman , Resham Shahzadi , Kadri Shazia , Riaz Shazia , Hamid Syed Ahmer , Ghafoor Tariq , Imam Uzma , Mushtaq Yaseen Rauf , Rana Zulfiqar Ali , Bouffet Eric , Minhas Khurram 
Published: February 2024

Introduction

Initiated in June 2019, this collaborative effort involved 15 public and private sector hospitals in Pakistan. The primary objective was to enhance the capacity for pediatric neuro-oncology (PNO) care, supported by a My Child Matters/Foundation S grant.

Methods

We aimed to establish and operate Multidisciplinary Tumor Boards (MTBs) on a national scale, covering 76% of the population (185.7 million people). In response to the COVID-19 pandemic, MTBs transitioned to videoconferencing. Fifteen hospitals with essential infrastructure participated, holding monthly sessions addressing diagnostic and treatment challenges. Patient cases were anonymized for confidentiality. Educational initiatives, originally planned as in-person events, shifted to a virtual format, enabling continued implementation and collaboration despite pandemic constraints.

Results

A total of 124 meetings were conducted, addressing 545 cases. To augment knowledge, awareness, and expertise, over 40 longitudinal lectures were organized for healthcare professionals engaged in PNO care. Additionally, two symposia with international collaborators and keynote speakers were also held to raise national awareness. The project achieved significant milestones, including the development of standardized national treatment protocols for low-grade glioma, medulloblastoma, and high-grade glioma. Further protocols are currently under development. Notably, Pakistan's first pediatric neuro-oncology fellowship program was launched, producing two graduates and increasing the number of trained pediatric neuro-oncologists in the country to three.

Discussion

The initiative exemplifies the potential for capacity building in PNO within low-middle income countries. Success is attributed to intra-national twinning programs, emphasizing collaborative efforts. Efforts are underway to establish a national case registry for PNO, ensuring a comprehensive and organized approach to monitoring and managing cases. This collaborative initiative, supported by the My Child Matters/Foundation S grant, showcases the success of capacity building in pediatric neuro-oncology in low-middle income countries. The establishment of treatment protocols, fellowship programs, and regional tumor boards highlights the potential for sustainable improvements in PNO care.