Towards zero percent abandonment is a project which piloted in Blantyre, Malawi in 2019. It aims to eliminate incomplete treatment. Incomplete treatment (abandonment of treatment) is a common cause of treatment failure in low-income countries. Strategies to enable parents to complete the treatment of their child (and prevent so called ‘abandonment of treatment’) include full cover of transport costs, free medical treatment, a tracking system to remind patients of appointments and more systematic and improved counselling of parents of the need to complete treatment. We aim to start this project in all centres participating in CANCaRe Africa and to enable all parents to complete the treatment of their child.
Please find some information and background about the efforts in Malawi to prevent ‘abandonment’ of treatment.
Results, impact and publications
We did a ‘baseline assessment’ in Blantyre, Malawi in 2018 and 2019 and found that 19% of children with common and curable cancers were not able to complete treatment.1 This was for non-medical reasons such as poverty (no money to pay for the bus to come to the hospital).
We documented how many children were able to complete their treatment after supportive interventions including full cover of transport costs, free medical treatment, a tracking system to remind patients of appointments and more systematic and improved counselling of parents of the need to complete treatment. Preliminary results indicate that the proportion of children not completing treatment decreased from 19% to below 5%.
1 Chakumatha et al. Outcome at the end of treatment of patients with common and curable childhood cancer types in Malawi. Ped Blood Cancer 2020.
Israels et al. The guardians’ perspective on paediatric cancer treatment in Malawi and factors affecting adherence. Ped Blood Cancer 2008. (SIOP members can access the article free of charge via “My SIOP” – “Read Journal”)
Zero abandonment – From Start to Finish
The results in Malawi give us hope and we would like to expand this project to all hospitals in sub-Saharan Africa which are participating in CANCaRe Africa. We are currently exploring partnerships and hope to find help and funding to support more families of children with cancer in Africa.
Sport events combined with fundraising efforts can be a powerful way to create funds to support the families. Current plans include a bike ride in Malawi along lake Malawi, a challenging and wonderful hike in Malawi in the Mulanje mountains and many more.