Methodology
In March 2017, a workshop at the 12th Annual SIOP Africa Congress in Marrakech, Morocco, convened 50 nurses from Francophone and Anglophone Africa (see Figure 1) to identify the strengths and weaknesses of the pediatric oncology nursing workforce in their settings, guided by a projected slide with a table of Strengths/Weaknesses/Opportunities/Threats (SWOT) in English and French for analysis 9. Time constraints precluded completion of the exercise, so opportunities and threats were not documented. Two bilingual moderators led the discussion as the nurses’ oral answers were documented on a flip board for the audience to consider. Suggestions supported by >80% of participants were documented.
In 2018, SIOP conducted a mapping exercise by an online survey to identify global childhood cancer services, beginning in Africa10\sout. The only nurse-specific data was the number of nurses working 75% of their time in pediatric oncology units. However, to demonstrate the burden of care for these nurses, data on allied health professional support available, including psychologist/psychiatrist, dietician/nutritionist, physiotherapist, social workers, pharmacist, and palliative care teams were also extracted from survey responses. Additionally, data regarding spiritual/religious, volunteer and patient/family support groups were extracted, and the presence of dedicated pediatric oncology units and access to pediatric intensive care units.
In March 2019, at the 13th SIOP Africa Congress in Cairo, Egypt, 30 nurses from Egypt, Tanzania, Morocco, Uganda and Cameroon participated in a two-day workshop to identify research priorities for pediatric oncology nurses in Africa. Participants formed small groups and submitted research questions to share with the larger group. Submissions were collected, collated and duplicates removed. Responses were thematically coded using ATLAS. ti version 8. Themes were grouped first by research priorities and second by the target population.
During the same meeting in Cairo, the nurse attendees initiated a project to identify the educational priorities of sub-Saharan nurses caring for children/adolescents with cancer. Following the Congress, an online Delphi Survey in English and French using REDCap was distributed to a convenience sample of nurses from sub-Saharan Africa with experience of at least one year caring for children with cancer11. The sample was recruited with a snowball methodology using existing networks of childhood cancer nurses in both Anglophone and Francophone Africa, as well as an extensive WhatsApp group of 172 members. In the first round, participants were asked to identify a minimum of 10 and a maximum of 20 topic areas for inclusion in a ’foundation’ level programme for pediatric oncology nurses. In the second round, participants were asked to rate the importance of each topic identified on a five-point Likert scale with the aim of 80% consensus on the topics to be addressed. In round three, participants were presented with a proposed outline framework of a nursing curriculum and asked to express agreement with the wording and grouping of topics into modules to develop an outline curriculum framework.
In 2022, at the 14th SIOP Africa Congress in Kampala, Uganda, approximately 50 nurses gathered once again from Francophone and Anglophone countries. The nurses were asked to write one sentence in English about their priority for pediatric oncology nursing in Africa using an anonymous google form. Comments were collected on a google form, and inductive thematic analysis was conducted using ATLAS.ti 9.