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.