Current status and priorities of paediatric oncology nursing in Africa: a synthesis of perspectives from SIOP Africa nurses.

Introduction: As African countries adopt the global goal of improving childhood cancer survival to 60% by 2030, intentional actions are required to improve nursing. This report aims to describe the current status of paediatric oncology nursing in Africa. Methods: We report on nursing-related aspects of a survey to map paediatric oncology services in Africa (2018-2019), document perceived nursing strengths and weaknesses (2017) and share nurses' research priorities (2019). Additionally, we report on a survey to identify topics for a foundation course (2019) and the expressed perspective of African nurses about the status of paediatric oncology nursing across the continent (2022). Results: Only 21% of respondents in the African mapping survey reported having nurses who care for children with cancer at least 75% of the time. Many centres do not have allied health workers like dieticians and play therapists, thus contributing to the nursing burden of care. The main strength of African paediatric oncology nurses was the humanisation of care, while the major weakness was the lack of training follow-up. The top research priorities focused on professional practice and psychosocial support. The Delphi survey identified 57 topic areas grouped into a 12-module curriculum for nurses new to paediatric oncology. The nurses affirmed their dedication to providing compassionate care, however, noted their vulnerability to harm and called for better specialisation, recognition and remuneration. Conclusion: This paper amplifies the voice of African paediatric oncology nurses. It illuminates the room for improvement and provides a reference point for future comparison.

The threat of the COVID-19 pandemic on reversing global life-saving gains in the survival of childhood cancer: a call for collaborative action from SIOP, IPSO, PROS, WCC, CCI, St Jude Global, UICC and WHPCA.

The COVID-19 pandemic poses an unprecedented health crisis in all socio-economic regions across the globe. While the pandemic has had a profound impact on access to and delivery of health care by all services, it has been particularly disruptive for the care of patients with life-threatening noncommunicable diseases (NCDs) such as the treatment of children and young people with cancer. The reduction in child mortality from preventable causes over the last 50 years has seen childhood cancer emerge as a major unmet health care need. Whilst survival rates of 85% have been achieved in high income countries, this has not yet been translated into similar outcomes for children with cancer in resource-limited settings where survival averages 30%. Launched in 2018, by the World Health Organization (WHO), the Global Initiative for Childhood Cancer (GICC) is a pivotal effort by the international community to achieve at least 60% survival for children with cancer by 2030. The WHO GICC is already making an impact in many countries but the disruption of cancer care during the COVID-19 pandemic threatens to set back this global effort to improve the outcome for children with cancer, wherever they may live. As representatives of the global community committed to fostering the goals of the GICC, we applaud the WHO response to the COVID-19 pandemic, in particular we support the WHO's call to ensure the needs of patients with life threatening NCDs including cancer are not compromised during the pandemic. Here, as collaborative partners in the GICC, we highlight specific areas of focus that need to be addressed to ensure the immediate care of children and adolescents with cancer is not disrupted during the pandemic; and measures to sustain the development of cancer care so the long-term goals of the GICC are not lost during this global health crisis.

Oncology nursing workforce: challenges, solutions, and future strategies.

The global oncology nursing workforce is essential to achieving Sustainable Development Goals 3.4 (reduce non-communicable disease morbidity by a third by 2030) and 3.8 (universal health coverage). Unfortunately, challenges to a robust oncology nursing workforce include nursing shortages, recruitment barriers (eg, perceptions of a demanding specialty with complex care and hazardous work environments), and burnout. Innovative recruitment strategies, onboarding and continuing education programmes, occupational safety measures, and burnout prevention interventions are documented solutions. The long-term effect of COVID-19 on oncology care worldwide is unknown, but immediate therapy interruptions, workforce consequences, and threats to standard oncology nursing practice are addressed here. Retention of experienced oncology nurses is crucial for future cancer control in all countries and must be addressed, particularly in resource-constrained countries with few oncology nursing staff and continuing out-migration of nurses to resource-rich countries. As the cancer burden worldwide increases, the future of the oncology nursing workforce is reflected in the call from the International Council of Nurses, Nursing Now, and WHO for nurses to move to higher levels of leadership, advocacy, and policy making (ie, national cancer control planning) and assume responsibility for their key role in achieving global goals for cancer control.

Improving Care for Children With Cancer in Low- and Middle-Income Countries--a SIOP PODC Initiative.

The Paediatric Oncology in Developing Countries (PODC) committee of International Society of Paediatric Oncology (SIOP) has 10 working groups that provide a forum for individuals to engage, network, and implement improvements in the care of children with cancer in low- and middle-income countries. The development of adapted guidelines (medulloblastoma, retinoblastoma, Wilms tumor, neuroblastoma, retinoblastoma, Burkitt lymphoma, supportive care), advocacy and awareness (on hospital detention and essential drugs), education and training, and global mapping (nutritional practice, abandonment rates, and twinning collaborations) have been the initial areas of focus, and the impact of some of these activities is evident, for example, in the SIOP Africa PODC Collaborative Wilms tumor project.

Testing efficacy of teaching food safety and identifying variables that affect learning in a low-literacy population.

Nurses at a meeting of the Asociación de Hemato Oncología Pediátrica de Centroamérica y El Caribe recognized food safety as one of the main issues affecting patient care. The objective was to increase awareness of food safety issues among caregivers for pediatric cancer patients in Guatemala and El Salvador. A low-literacy booklet about food safety, "Alimentación del niño con cáncer (Feeding the child with cancer)," was developed for caregivers. Tests were developed to assess information acquisition and retention. An educator's guide was developed for consistency of education along with a demographics questionnaire. The efficacy of the booklet was tested with 162 caregivers of patients with newly diagnosed leukemia. Information retention was tested 1 and 3 months after the initial education. The booklet was found to be efficient for food safety education. There was no significant difference between post-educational knowledge in either country at 1 month or in Guatemala at 3 months. Pre-educational knowledge was not associated with any demographic variable except for self-reported ability to read in El Salvador. There was no significant association between learning ability and demographic variables in either country. Caregivers from El Salvador had a better ability to learn than caregivers from Guatemala. Education using the booklet greatly improved food safety knowledge, which remained high 1 and 3 months later. Education with the booklet was efficacious for teaching a low-literacy population about food safety. However, it is unknown which part of the education contributed to the significant improvement in knowledge.

Educational needs and strategies of pediatric oncology nurses in low- and middle-income countries. An International Society of Pediatric Oncology- Pediatric Oncology in Developing Countries Nursing Working Group Initiative.

BACKGROUND: There is no existing pediatric oncology nursing curriculum written specifically for low- and middle-income countries (LMICs), where 80% of children with cancer reside. In 2012, the International Society of Pediatric Oncology Nursing Working Group sought to address this gap with a 3-phase study. OBJECTIVE: Phase 1: identify educational priorities of LMIC nurses providing oncology care. Phase 2: solicit educational strategies from expert pediatric oncology nurses. Phase 3: develop a culturally adaptable modular curriculum framework based on LMIC nurses' priorities. METHODS: A cross-sectional sample of LMIC nurses were surveyed (including Africa, Latin America, Asia). Next, 2 rounds of a Delphi survey were sent to expert pediatric oncology nurses from high-income countries with experience working in LMICs. A 2-day workshop was conducted to develop the framework. RESULTS: Low- and middle-income country nurses' survey responses indicated a similar need for specialty training (eg, chemotherapy and psychosocial support). Delphi survey participants agreed on educational strategies (eg, group discussions and peer teaching). Finally, 5 LMIC nurses committed to creating curriculum modules. CONCLUSIONS: There is an urgent need for a curriculum framework created and field tested in LMICs. The International Society of Pediatric Oncology 3-phase project was a successful strategy for initiating this ongoing process. IMPLICATIONS FOR PRACTICE: Translating or modifying existing oncology nursing curricula from high-income countries for use in LMICs is no longer adequate. Engaging LMIC nurses who care for children and adolescents with cancer in curriculum development, recognizing local cultures, traditions, and priorities and harnessing the LMIC nurses' knowledge, experience, and resources are the logical solution for a relevant curriculum.