Building a Pediatric Oncology Nutrition Program at Yangon Children’s Hospital in Myanmar: A Multidisciplinary Collaboration
Yangon Children’s Hospital (YCH) is the largest public, pediatric hospital in Myanmar. The Hematology/Oncology (HOU) department treats more than 400 patients per year with rates on the rise. Approximately two-thirds of children with cancer at YCH are malnourished. Poor nutrition is associated with treatment toxicity, poor treatment response, and decreased survival in children with cancer.
Where we started
Previously, YCH/HOU had no formal nutrition program. While the local donor community provided meals for inpatients, inconsistent access to supplemental nutrition, lack of trained personnel, and inadequate educational resources hindered appropriate support for malnourished cancer patients. In 2017, YCH and Boston Children's Hospital embarked on a nutrition-focused collaboration, and with support from international and local donors, a formal inpatient nutrition program launched in 2019.
Since the program launch, more than 400 inpatient children have been evaluated for malnutrition by a full-time nutritionist. Families now receive one-on-one nutrition counseling. Each month about 100 nutrition packages of milk, formula, and food are provided to malnourished children. More than 100 nurses have attended nutrition-focused lectures. Additionally, a core group of parents, teachers, social workers, and nurses participated in advanced, interactive nutrition educational sessions to prepare them to serve as peer leaders and educators.
A comprehensive nutrition curriculum and training guide is in development in collaboration with the WHO Global Initiative for Childhood Cancer. Education materials tailored to the local culture are being created for children and caregivers. Hospital renovations are underway to create kitchen space for the safe storage and preparation of food and supplements. Next steps include increasing YCH outpatient nutrition services and expanding to a sister hospital in Mandalay, Myanmar.
Erin Gordon, MS, RD, LDN, CDCES
Improving outcomes for cancer patients in Myanmar
At Yangon Children’s Hospital, the Dana-Farber/Boston Children’s Global Health Initiative (GHI) is partnering with pediatric oncology physicians and nurses in-country to improve outcomes for children with cancers and life-threatening blood disorders through program building, education, and research. The GHI is an interdisciplinary program of faculty, fellows, nurses, social workers, psychologists, health educators, and managers working to improve outcomes for children with cancer and blood disorders in countries with limited resources. Boston Children’s Hospital nurses who have worked in the field on the GHI include Colleen Nixon, Kathleen Houlahan, Lisa Morrissey, and Marilyn Moonan. Primary goals include building centers of excellence in pediatric hematology and oncology in the developing world, training the next generation of leaders, and establishing new lines of research in global health.