Implementation of the Adult Oncology Unit at Muhimbili National Hospital (MNH)

Abstract

The escalating cancer burden, particularly in low- and middle-income countries such as Tanzania, necessitates innovative strategies. One such strategy is increasing access to cancer services through the establishment of treatment in existing referral hospitals that offer multidisciplinary care, as was the case in the opening of the adult oncology unit at Muhimbili National Hospital (MNH) in Tanzania to address the burgeoning cancer crisis. A comprehensive facility assessment served as the foundation for this transformation, ensuring optimal resource allocation and effective implementation. The rising cancer burden in Tanzania is dominated by cervical, breast, and prostate cancers. However, reported figures might underestimate the issue due to the lack of a centralized national cancer registry and limited access to diagnostic and treatment facilities throughout the country. The MNH oncology unit's creation aimed to decentralize care from the Ocean Road Cancer Institute (ORCI); as the cancer burden increased over the years, the center was getting strained by demand. The MNH facility assessment encompassed assessments of spatial requirements for human resources, equipment, and drug availability. This unit adopts a multidisciplinary approach, enabling personalized treatment plans and collaborative decision-making, aimed at expanding capacity and promoting inter-departmental cooperation. A "train-the-trainer" model empowered nursing staff in chemotherapy administration, and pharmacist involvement ensured accurate medication management. This initiative has substantially improved patient outcomes, with reduced wait times for oncology care initiation, facilitating seamless care coordination that capitalizes on multidisciplinary treatment planning. The opening of the oncology unit has given benefits to MNH through fostering multidisciplinary collaboration, an increase in revenue generation, and the expansion of care that aligns with institutional goals. Nonetheless, challenges, including space constraints and an inadequate number of trained human resources for oncology care, persist. The successful establishment of MNH's adult oncology unit exemplifies stakeholder engagement, adaptability, and the significance of collaboration. A comprehensive approach, emphasizing workforce development, community awareness, and infrastructure enhancement, offers promise in confronting Tanzania's mounting cancer burden.