Grant: Project Grant

Childhood cancer care in low- and middle-income countries (LMICs) like Nepal faces critical challenges due to inadequate health system capacity, leading to delays in diagnosis and treatment and poor outcomes. Strengthening these systems is essential for equitable, high-quality care and improved survival. This study aims to enhance Nepal's health system capacity and readiness to deliver a comprehensive, systems-based approach to childhood cancer care. This three-year, multi-site study will establish a prospective cohort of children (0-19 years) newly diagnosed with cancer at four tertiary hospitals, which treat 80% of childhood cancer cases nationally. Through rigorous longitudinal data collection, we will generate critical evidence to improve childhood cancer care in Nepal and inform broader health system strengthening in South-East Asia. Building on prior vanguard research and leveraging strong partnerships, this interdisciplinary, international collaboration aligns with the WHO's Global Initiative for Childhood Cancer. The study has four objectives: (1) quantify access, diagnostic, and treatment intervals in childhood cancer care and identify determinants of delays; (2) assess the quality of cancer diagnosis and treatment, and evaluate one- and two-year survival rates; (3) examine the financial burden of childhood cancer on families and the health system to inform financial protection strategies; and (4) assess health facility capacity to diagnose and treat childhood cancers, identifying system-wide gaps and opportunities for improvement. By integrating health systems research, epidemiology, and health economics, this study will generate a comprehensive landscape of childhood cancer care in Nepal. Findings will support evidence-informed policies, resource allocation, and interventions to strengthen childhood cancer care.