PDNO-15 CLOSING THE CARE ACCESS GAP FOR CHILDREN WITH CENTRAL NERVOUS SYSTEM TUMORS IN UGANDA: THE ROLE OF STAKEHOLDER ENGAGEMENT.

Abstract Background and Aims Central Nervous System (CNS) tumors are the most common cancer in children and a leading cause of cancer-related death in children and adolescents. Management of children with CNS tumors requires well-coordinated, highly specialized teams including neurosurgery, radiotherapy, radiology, pathology, pediatric oncology, supportive care, and rehabilitation services. Whereas access to these services is less challenging for children in high-income countries, significant barriers exist for children in low- and middle-income countries (LMICs). Before 2024, the management of children with CNS tumors in Uganda was fragmented: Cure Children’s Hospital of Uganda (CCHU) in Mbale performed brain tumor surgeries, while adjuvant care was divided between the Uganda Cancer Institute (UCI) and Mulago National Referral Hospital (MNRH) in Kampala, 200km from Mbale. Without a multidisciplinary team (MDT), patient care coordination was challenging. In December 2023, a consultative meeting between the leadership of CCHU and UCI was held to brainstorm the improvement of care access for children with CNS tumors. We aim to report the care access gaps identified by the team and the progress made towards plugging these gaps. Methods Team meetings were convened by the UCI head of pediatric hematology and oncology and held with 1) administrators of UCI and CCHU, 2) pathology, 3) radiotherapy, and 4) the rehabilitation team. Results 1) A Memorandum of Understanding was signed between CCHU and UCI 2) A multidisciplinary team formed in January 2024 discusses 2-3 patients each week, 3) A dedicated pediatric radiotherapy clinic was established in February 2025, 4) A pediatric CNS tumor registry is in place,5) A physiotherapy clinic runs alongside the pediatric neuro-oncology clinic and 6) Two quality improvement projects, one to improve time to diagnosis and the other to reduce time to radiotherapy. Conclusions Stakeholder engagements enabled us to objectively assess Uganda’s pediatric CNS tumor care and prioritize immediate interventions