National and institutional capacity building with international collaboration to advance pediatric neuro-oncology care in Ethiopia: a baseline need assessment survey.
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BACKGROUND: Pediatric neuro-oncology (PNO), which encompasses the diagnosis and treatment of brain and spinal cord tumors in children, represents a critical but underserved area of pediatric cancer care, especially in low- and middle-income countries such as Ethiopia. In Ethiopia, there is a significant gap between the burden of pediatric central nervous system (CNS) tumors and the availability of diagnostic and therapeutic services. OBJECTIVE: The main aim of this study was to assess the current state of pediatric neuro-oncology care barriers, institutional capacity needs, and opportunities for international collaboration to guide the development of a strategic road map for advancing PNO care in Ethiopia. METHODS: A cross-sectional survey was conducted among 160 health professionals working on pediatric cancer related care with a response rate of 76.2% (160/210) using snowball sampling technique from July 20–31, 2025. Data was collected using a structured and anonymous self-administered online questionnaire prepared using google format and disseminated to participants via email. The prepared questionnaire included demographic and professional background, current capacity and challenges in PNO care in Ethiopia, perceived institutional capacity-building needs, opportunities for international collaboration, and perspectives on national and international collaboration for PNO care in Ethiopia. RESULTS: Among health professionals who participated in this study, 122 (76.3%) were males and 76.3% of respondents were aged between 30 and 45 years. The survey results revealed widespread systemic challenges across institutions; with the majority of respondents reporting substantial gaps in essential infrastructure and services. Nearly half of the respondents (42.5%) reported that fewer than 25 PNO cases were diagnosed and treated annually in their hospitals. At the time of the survey, Tikur Anbessa Specialized Hospital hosted the only Pediatric Neuro-Oncology (PNO) tumor board in the country. The study finding revealed serious limitations in molecular diagnostic services (85.0%), unavailability of immunohistochemistry services (75.0%), and 92 respondents (57.5%) reported the absence of a PNO training program in their institutions. About 77 respondents (48.1%) reported a lack of access to radiotherapy services. The majority also expressed interest in participating in such capacity-building initiatives. CONCLUSION: There was strong interest in participating in a coordinated national initiative to advance PNO care, alongside an urgent need to establish a national capacity-building program and a dedicated PNO tumor board at the institutional and national level in Ethiopia.