1. 714 children have been diagnosed with cancer at Queen Elizabeth Central Hospital (QECH) by the end of the project.
2. 240 ward staff and 45 nurses at QECH have been trained in childhood cancer management by the end of the project.
3. 519 healthcare workers have been trained in the early warning signs and symptoms of childhood cancer by the end of the project.
    

• World Child Cancer UK will deliver training on the early warning signs and symptoms of childhood cancer to 519 frontline healthcare workers.
   
• World Child Cancer UK will implement public awareness activities so that parents can spot potential early warning signs of cancer and seek medical help quickly.
   
• World Child Cancer UK will facilitate two health partnership visits per year, arranging for senior paediatric oncologists from the UK to train and support 80 ward staff in Malawi in childhood cancer management.
   
• Two nurses who have received a Training of Trainers training will cascade the training to 45 nurses to equip them with essential knowledge and skills to provide the most appropriate nursing care to sick children, and thus improve health outcomes.
   
• To facilitate sustainable healthcare strengthening in Malawi, we will work in partnership with key stakeholders to raise the focus on childhood cancer within the government and to encourage them to apply for Malawi to become a focus country for the WHO Global Initiative for Childhood Cancer (GICC).
   
• World Child Cancer UK will provide a central fund for 1,038 children with cancer and their families, to cover the costs of vital drugs, transport to hospital, and ‘welcome packs’ containing essentials such as food, nappies, and hygiene items. This financial support will prevent vulnerable families from falling further into poverty, and will contribute to a reduction in the high numbers of families who abandon treatment, which ultimately leads to children not surviving cancer. 
   
• World Child Cancer UK will pay for Queen Elizabeth Central Hospital to refer children’s pathology samples to an external private laboratory for tests which are not available in its pathology lab.
• We will coordinate quarterly ‘follow-up’ contacts to the families of all patients in treatment in order to remind them about medical appointments.
   
• World Child Cancer UK will improve the wellbeing of 685 children undergoing inpatient treatment through the provision of play therapy and the provision of interactive educational materials about their illness. This will empower children with cancer – and their caregivers – to understand the diagnosis the child receives, the medical procedures they will undergo, and the importance of remaining in treatment.

All the work World Child Cancer UK will carry out will be fully embedded in existing local infrastructures, which will enable sustainable change. The project will be led, and sustained, by healthcare professionals in local hospitals and medical centres, with buy-in and support from the Malawi Ministry of Health.

Through the advocacy work, they aim aim to contribute to convincing the government of Malawi to strengthen its support for childhood cancer, and to apply to become one of the focus countries for the WHO Global Initiative for Childhood Cancer (GICC).

The project will strengthen the capacity at Queen Elizabeth Central Hospital and in the district hospitals supported in the long-term. As regards healthcare professionals trained, they will continue to recognise and refer suspected cases of childhood cancer throughout their careers, and will be able to share and cascade their training to peer colleagues.

The sharing of knowledge and expertise facilitated through the project’s health partnership visits will develop skills so that healthcare staff can provide higher quality long-term paediatric cancer care. The nurses who receive a Training of Trainers training will cascade the training to 45 nurses to equip them with essential knowledge and skills to provide the most appropriate nursing care to sick children. After project end, this knowledge will continue to be cascaded at no additional cost to new nurses who join QECH.  

By improving access to early diagnosis, children will need fewer heavy treatments and futile rounds of chemotherapy will be reduced, as will time families spend in hospital and travelling to hospital, which renders at least one carer economically inactive. This will save money for both families and hospitals. 

As regards the future financing of the Malawi programme: by supporting the Ministry of Health to become a WHO GICC focus country and endeavouring to have access to the Global Platform for Access to Childhood Cancer Medicines, we will improve access to significant and sustainable sources of funding and support towards childhood cancer in Malawi.

To facilitate sustainable healthcare strengthening in Malawi, World Child Cancer UK will work in partnership with key stakeholders to raise the focus on childhood cancer within the government and to encourage them to apply for Malawi to become a focus country for the WHO Global Initiative for Childhood Cancer (GICC). They will organise an exchange visit with Ghana to learn from their experience of applying to become a GICC focus country, and will facilitate the regional sharing of learning between the Malawian and Ghanaian governments.