Establishing a national shared care network for paediatric oncology in Cameroon: Development process, baseline findings and early lessons.
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BACKGROUND: Childhood cancer survival in sub-Saharan Africa remains below 30%, largely due to delayed diagnosis, weak referral systems, and limited specialised services. To improve access and continuity of care, Cameroon launched a national Shared Care Network (SCN) for paediatric oncology in 2023 under the WHO Global Initiative for Childhood Cancer and within the CureAll framework. This study aimed to describe the development process, baseline findings, network design, and early lessons from establishing Cameroon's national paediatric oncology Shared Care Network. METHODS: A baseline assessment using the International Society of Paediatric Oncology (SIOP) Global Mapping Survey was conducted in ten hospitals across six regions. Data were collected on oncology infrastructure, staffing, diagnostic and treatment capacity, and access to supportive services. Centres were classified according to service level, and findings were validated through stakeholder workshops involving the Ministry of Public Health, the National Committee for the Fight Against Cancer (NaCFAC), and partner organisations. These findings informed centre classification, referral pathway design, service package definition, workforce training priorities, and development of a national SCN implementation manual. RESULTS: Two hospitals: Mbingo Baptist Hospital and the Mother and Child Centre, Chantal Biya Foundation were designated as hub centres with full oncology services. Eight others function as shared-care centres, providing basic chemotherapy and diagnostics with referral links to the hubs. All facilities had access to X-ray and ultrasound, while CT scans and paediatric surgery were available only at the hubs. None had immunohistochemistry or radiotherapy. Forty-nine healthcare workers were identified, including five paediatric oncologists and thirty-five trained nurses. Psychosocial and rehabilitative services were available in only three centres. Civil society groups provided key support in transport, accommodation, and drug procurement. The development process produced a nationally validated SCN framework with defined hub and shared-care roles, referral pathways, service packages, and training priorities. CONCLUSION: The establishment of Cameroon's SCN demonstrates the feasibility of developing a coordinated and decentralised paediatric oncology network within an existing health system in a resource-limited setting. Integrating the SCN into national policy, investing in diagnostics, and institutionalising training will be essential for sustainability and scaling toward universal coverage and improved childhood cancer survival in Cameroon.