Study procedure and data collection
The questionnaire we used for the study was developed by adapting
questions from different questionnaires including, the Impact Assessment
for improving outcomes of cancer strategies developed by the government
of the United Kingdom. The adapted questionnaire was jointly reviewed
and validated in stakeholder meeting at the national committee for the
fight against cancer prior to data collection. The final questionnaire
had sections to collect information on pediatric cancer service
availability (chemotherapy, radiotherapy, nuclear medicine), human
resource capacity, chemotherapy treatment completion, patient education
and disclosure of status as well as data management. Following
administrative authorization from Cameroon’s Ministry of Health (MOH),
we deployed trained data collectors to the MCC/CBF, who used the
approved questionnaire to collect the required data; however, due to
security risks in the North-West Region, these data collectors could not
visit the MBH. As a result, we sent a copy of the tool to two of the
co-authors of this paper (GMA and FT) electronically, who in turned
leveraged it to collect the necessary data. To understand reasons for
drop-out, families identified as loss to follow-up were contact traced
through phone calls and their reason for discontinuing treatment was
recorded.