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

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