ID #716 Assessment of pediatric neuro-oncology capacity in Uganda using the PANORAMA tool a cross-sectional resource analysis
Racheal Angom, Tomson Katungi-Mabare, Veronica Nyakato, Nixon Niyonzima, Geraldine Kauma, Beatrice Rukundo, Joyce Balagadde-Kambugu, Emmanuel WegoyeAbstract
Background
Pediatric central nervous system (CNS) tumor care is complex and resource-intensive. In low-income countries, a systematic assessment of service capacity is essential to identify gaps and prioritize interventions that improve care. The PANORAMA (PediAtric Neuro-Oncology Resources AssessMent Aid) tool was developed to evaluate pediatric neuro-oncology services. This study sought to evaluate the capacity and identify gaps in pediatric neuro-oncology services at two collaborating hospitals in Uganda: Uganda Cancer Institute (UCI) and Cure Children’s Hospital of Uganda (CCHU).
Methods
A cross-sectional, facility-based assessment was conducted using the PANORAMA tool, comprising quantitative and qualitative items across 13 domains. Data collection involved a local assessor at UCI completing a structured electronic survey in REDCap. Quantitative responses were analyzed using a predefined scoring algorithm, with domain performance rated as A (≥80%), B (60–79%), or C (<60%).
Results
UCI demonstrated strong infrastructure with A-rated performance in National Context (80%), Hospital Profile (86%), Organization & Integration (81%), and Finance (82%). Critical gaps emerged in specialized diagnostics: Pathology scored 50% (C) with no neuropathologist and 15–28-day final report delays. Furthermore, gaps in multimodal therapy were identified: Radiotherapy scored 54% (C) with 2-4 month wait times and no CNS-specific protocols; Chemotherapy scored 53% (C) with no standardized protocols or targeted therapies.There were critical deficits in specialized staffing.
Conclusion
While the UCI/CCHU collaboration has a strong foundation, critical gaps remain in pathology, precision diagnostics, and protocolized treatment. Priority areas for intervention include capacity-building in neuropathology, protocol standardization, specialist training, and improving access to radiotherapy. The PANORAMA tool, with its multi-dimensional gap analysis, provides an actionable framework for quality improvement in resource-variable settings.
1. Rajagopal R, Diaz-Coronado R, Hamid SA, et al. OTHR03. Development of PANORAMA: an assessment tool for pediatric neuro-oncology service delivery capacity. Neuro Oncol. 2024; doi:10.1093/neuonc/noae064.674.