Setting Priorities in Childhood Cancer in Low Income Countries Using Nominal Group Technique: Experience from an International Childhood Cancer Forum Exercise in Bangladesh

Abstract

Background and Objectives: Cancer is one of the major causes of mortality and morbidity worldwide. The<br />incidence of paediatric cancer in particular, in Bangladesh is alarming and most of these patients die without correct<br />diagnosis and adequate medical treatment (MOHFW, 2008). There is a clear disparity in access to care between rural<br />and urban areas (WHO, 2015; Rahman, 2001). There are no established formal childhood cancer registry systems<br />to help inform planning decisions across the country. Most importantly, there are no explicit priorities or methods<br />for identifying such priorities in Low and Middle Income Countries (LMICs). We used a Nominal Group Technique<br />(NGT) method during the International Childhood Cancer Forum (ICCF) for setting priorities. The following two key<br />objectives were addressed: Trialling the NGT in Bangladesh as a priority setting tool; and identify childhood cancer<br />priorities in Bangladesh. Methods: The Nominal Group Techniques (NGT) method was used to elicit information from<br />the participants of ICCF to identify priorities for research and interventions for childhood cancer care in Bangladesh.<br />Participants were divided into four groups. Each group discussed one question each. Two questions focused on cancer<br />research, and the other two focused on interventions. Results: In regards to outcomes, NGT successfully identified<br />the scale of childhood cancer care and identified priorities/action areas to address in Bangladesh. Six priorities were<br />identified and a successful collaboration for implementation has been established with several international organisations.<br />Conclusion: Nominal group technique was found to be an effective tool to identify research and intervention priorities<br />to address childhood cancer in a developing country. For resource limited countries in similar situations, they could<br />benefit from adopting this approach in healthcare settings.