Setting Up a Pediatric Radiation Oncology Program in Sub-Saharan Africa: Report From Nigeria

Purpose: This report summarizes the establishment and implementation of the first dedicated pediatric radiation oncology program in Nigeria. The program was developed to improve clinical outcomes, increase professional capacity, and advance regional research and protocol development. Methods and Materials: Key considerations included professional development and capacity building, promoting multidisciplinary communication and practice, and incorporating technology for improved communication and data management. Regional and international collaborations were instrumental in addressing these considerations and ensuring the program's success. The program encountered challenges, including difficulties in recruiting team members, high rates of treatment abandonment, gaps in clinical and pathological information, as well as inadequacies in diagnostic testing capabilities. Results: This pioneering pediatric radiation oncology unit in Nigeria was established with a multidisciplinary team comprising radiation oncologists, medical physicists, radiation therapy technologists, nurses, trainee medical doctors, and a dedicated research associate. The facility is equipped with 3 linear accelerators capable of delivering advanced conformal 3-dimensional radiation therapy such as intensity modulated (IMRT) and volumetric modulated arc radiation therpay (VMAT). Within a 4-year duration, the program received 210 pediatric referrals, of which 55.7% proceeded to undergo radiation treatment. Innovative, context-specific, feasible, and sustainable solutions were necessary to address the unique challenges of the region. Conclusions: This report details the establishment process, achievements, and strategies employed to overcome common barriers in commencing a pediatric radiation program in sub-Saharan Africa, in order to serve as a replicable model for advancing pediatric radiation oncology practice in regions with similar health care and socioeconomic contexts.