The news of the diagnosis in children is received with anxiety, astonishment, and sorrow regardless of social class and status. Hitherto, the National Health Insurance Scheme (NHIS) did not cover the treatment of these diagnoses, adding on to the overwhelming bewilderment when parents are informed of total cost involved for treatment.
With limited higher treatment centres in Ghana, affected children are referred from the district and regional hospitals. The Greater Accra Region for instance, has only two of such higher treatment centres, the Korle-Bu Teaching Hospital and the Greater Accra Regional Hospital, Ridge. Upon patient contact, an array of laboratory investigations and imaging studies are requested as part of the initial steps of diagnosis.
Admissions may be required once diagnosis are confirmed. During these periods, the children require supportive therapies including blood products transfusions, intravenous infusions, oral and intravenous medications. These therapies aim at achieving optimal states prior to the commencement of treatments.
Treatment durations vary and span from an average of 6months to 2-3years depending on the type of cancer diagnosis. . The modalities of childhood cancer treatment include Chemotherapy, Surgery and RadiotherapyThese may vary depending on the type of cancer and metastasis (extent of spread to other parts of the body). Inadvertently, some children experience stormy periods whilst on treatments and may require prolonged hospitalization. Such situation results in absenteeism at work and other schedule disruptions of their parents with some losing their jobs in rare instances.
Childhood cancer is an identifiable social burden with untoward replications to the family and society. The management of Paediatric Oncology Patients (POP) therefore, involves a multidisciplinary approach with a Consultant Paediatric Oncologist leading the treatment team. Through collaborated efforts of a multidisciplinary team of Paediatric oncologists, heamatologists, fellows, nurses, pharmacists, specialist surgeons of various disciplines, interventional radiologists and psychologists, these children are guided through the murky road of cancer.
Counselling sessions are an integral aspect of the preliminary stage of the treatment process. Parents are engaged by the team to understand and assimilate the conditions of their children and the entire scope of the treatment process.
The engagement of clinical psychologists is imperative to the treatment process, as parents require the mental readiness and encouragement to brace themselves for the surmountable journey ahead.
The importance of these sessions cannot be over-emphasized enough, curtailing treatment abandonments, one of the limiting factors in childhood cancer survival.
Childhood cancer treatment is expensive, irrespective of the diagnosis. The Paediatric Oncology Unit of Department of Child Health, Korle-Bu Teaching Hospital thrives on philanthropic gestures and efforts from the society in meeting these high-cost needs of treatment. Regular and unsolicited donations from religious bodies like the International Central Gospel Church (ICGC)- Christ Temple, Immanuel Methodist Church-Spintex and other non-governmental organizations (NGOs) such as World Child Cancer-UK, Little Angels, Indian Ladies, Mofra Africa and recently PZ Cussons have come in very handy and diagnosed children and families benefit significantly from this support.
However, philanthropy and donor donation should not be the only way to finance Childhood cancer. A much more sustainable financial mechanism needed to be incorporated. A country could not achieve UHC by 2030 and make much in-roads with Sustainable Development Goal 3 ‘Ensuring Healthy Lives and Promoting wellbeing for all at all ages’, without catering for the well-being of these children.
The 15th of November,2021 will continually be etched on the hearts of every child in Ghana. On that day, during the launch of the NHIS week, the First Lady on the Land, Her Excellency Mrs Rebecca Akufo -Addolaunchedthe inclusion of the four common Childhood cancers onto the NHIS Benefit Package! These four, which constitute about 60% of all childhood cancers in the Country, are Burkitt Lymphoma, Wilm’sTumor, Acute Lymphoblastic Leukemia and Retinoblastoma.
The NHIS will pay for all direct cost needed for the management of Childhood cancers. Coverage includes cost of laboratory investigations, chemotherapy, radiotherapy, and surgery.
This news was greeted with joy, amidst dancing at the PediatricOncology units. Consultants hugged nurses… nurses carried Paediatric Oncology patients on their backs. The huge financial burden has been lifted off them. This is the hope given to all the Paediatric Oncology Patients (POP) seen day in day out at the Paediatric Oncology Unit (POU), Department of Child Health, Korle-Bu Teaching Hospital, and the KomfoAnokye Teaching Hospital, and those been catered for by shared facilities.
The addition of Childhood cancer to the NHIS is essential. It is cost-effective and will improve the survival of children with cancer. Now Akweley can dream of becoming the Doctor she has always wanted to be, as she has a whopping 80% chance of beating this cancer to a pulp! She can live a productive life, compete with any other child in this world, and contribute her quota to the economic growth of this country.
Finally, a bright light at the end of a dark, meandering road.