The Spectrum of Socio-Economic Barriers of Families of Children with Cancer during Cross-Border Care: A Paediatric Tertiary Care Hospital Experience

Abstract

Background: Childhood cancer care needs timely access to diagnostic, treatment, and follow-up services for better survival of these children. Unfortunately, there is a lack of established comprehensive childhood cancer centers in Afghanistan, so these children with cancer and blood disorders consult healthcare providers working cross-border to seek specialized care. The research to explore the distress linked with childhood cancer and associated socioeconomic hurdles is lacking in low-middle-income LMIC countries. Objective: To evaluate the challenges faced by these families while their children with cancer are being managed cross-border in Pakistan. Methodology: This is a cross-sectional study done at Children’s Hospital Lahore, Pakistan, from 1^st January 2023 to 31^st March 2023. The study involved families with twenty-four children. We interviewed the Afghan families of these children to understand the challenges they faced during this ordeal. Results: The study included children with a mean age of 7.4 years; only 21% were females. They spoke Pushto and Dari languages. Twenty-five percent did not understand Urdu, finding communication exceedingly difficult in 50% of families. Only 4 families had the facility of a translator. Sixty-seven percent were diagnosed with acute lymphoblastic leukemia, and the rest with solid malignancies. The monthly family income was meager. In 85% of cases, the remaining family was sponsored by loans or charity, and 75% were escorted by one or both parents. Ninety-five percent took loans and had a significant effect on siblings education and emotional well-being. Eighty-five percent declared the economic difficulties more disturbing than communication and logistic challenges. Conclusion: During cross-border care, immense challenges were faced by them, requiring efficient socioeconomic support and parental support groups.