Background: Effective treatment for WT requires a multi-modal approach. For WT patients in Rwanda, these modalities are offered at different health facilities and this can contribute to delays in care.At Butaro Cancer Center of Excellence (BCCOE) the Patient Navigation Program, was established to address barriers to paediatric cancer care completion, increase the timeliness of diagnosis and treatment, improve coordination of referral mechanisms, and reduce loss to follow-up with treatement among children with WT during the COVID- 19 pandemic.

Patient Navigation:The patient navigator(PN), educated the caregivers of newly diagnosed WT patiens on cancer treatement. The PN assessed barriers to care and addressed them through multidisciplinary collaboration. Further, the PN coordinated care by collaborating with clinicians from different institutions and connecting patients to them for seamless care delivery.
Medical appointments reminders were done through phone calls or short messages (SMS) and caregivers were called to follow-up on missed appointements. The PN ensured continuous conversation with patients for consolation and accompagniement throughout the stressful cancer journey.Patients transport was organized for patients from their homes to cancer centers to adhere to their treatments chedule during COVID 19 related travel restrictions.

PN Acceptability: Clinicians at BCCEO evaluated the PN program as bringing significant positive changes to the treamtment process. Fewer patients missed, abandoned or delayed cancer treatment due to the PN’s care coordination and ongoing follow-up with patients’ families and caregivers compared with a previously treated Wilms Cohort.
Caregivers appreciated the PN due to his accompanignement and provision of emotional support, that encouraged their adherence to planned treatment despite many socio-economic challenges. Appointment reminders and phone calls relieved stress and helped caregivers cope with their child’s disease.
Collaborators outside Butaro hospital especially pediatric surgeons based at CHUK appreciated the program because it helped them plan their surgery in advance thereby preventing patient treatment delays.