Professionals at the Princess Máxima Center share their skills and knowledge with colleagues in poorer countries, through the Outreach program. This video shows the impact of the program for patients and professionals in Kenya

Background

Kenya is located in the East coast of Africa. It has a population of about 50 million people, 40%  of whom live below the poverty line. There are about 20 million children in Kenya under the age of fifteen. The Moi Teaching and Referral Hospital (MTRH) serves the Western part of Kenya with a catchment population of about 20 million. It is an academic and a tertiary care referral hospital, which diagnoses 200 children with cancer per year. The government provides funding to the hospital though it is not enough to pay for all the costs incurred and a majority of the patients use out-of-pocket costs to pay for their medical expenses. Only 20% of the pediatric oncology patients have health insurance provided by the government owned national health insurance fund which enables them to cater for most of their inpatient hospital costs.

 

Facts & Figures
  • About 1000 children are expected to have childhood cancer in the service area of MTRH.

  • Only about 100 (<10%) of these childhood cancer patients get diagnosed.

  • Current survival rate about 30%.

  • Start collaboration: 2006.

  • Project leader at MTRH is Festus Njuguna, pediatrician (specializing in childhood oncology). At the Princess Máxima Center Gertjan Kaspers, pediatric oncologist leads the partnership. Also pediatric oncologist Valerie de Haas, pediatrician Erica Brivio, child life specialists Karin van Gils, Sanne Timmerman en Tirza Schuerhoff, nurse practitioners Rinske Meesters, Jeantine de Heus and Lisa Zwiers and lab technician Anja de Jong are part of the team.

Challenges
  • Lack of adequately qualified personnel.

  • A huge number of children are undiagnosed.

  • Delays in diagnosis and starting of cancer treatment.

  • Low awareness and knowledge on childhood cancer among health care workers and the general public.

  • High treatment abandonment rates (30%).

  • Poverty.

  • Long travel distances to the hospital.

  • Low health insurance uptake.

Key activities
  • Development of locally adapted treatment protocols.

  • Training of staff through an exchange program.

  • Health workers education through workshops.

  • Research to document local issues and formulate corrective measures.

  • Training of laboratory staff and development of standard operating procedures for various diagnostic tests.

  • Use of  teleconferences and online consultations for patient management.

​Outcome
  • Increased staff knowledge.

  • Better data collection.

  • Implementation of locally adapted protocols.

  • Increased health care workers awareness and knowledge about childhood cancer.

  • Many research papers published in peer reviewed international scientific journals.

  • The chance of survival has increased for certain types of cancer, (e.g. Willms tumor, ALL), although the survival rates in the Netherlands are still a lot higher.  

Impact
  • Improved outcomes with survival rate increasing from 20% to 30%

  • Reduced treatment abandonment from 50% to 30%

  • One completed PhD program, and two ongoing PhD programs

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