OnCo
ideasIdea

Cash for transport and food to stop families abandoning curative treatment

Many children and adults in poorer countries stop curable cancer treatment because families cannot afford the bus fare or food while in hospital. Small, reliable payments during treatment prevent this.

Treatment abandonment is the leading cause of treatment failure for childhood cancer in many LMICs, and is driven by transport cost, lost income, and lodging. Programmes providing conditional cash, transport vouchers, and family accommodation (in Central America, East Africa, and India) have cut abandonment dramatically at low cost. The proposal is to make an abandonment-prevention package a standard, funded component of every curative protocol in LMIC centres and to report abandonment as a quality indicator.

Hypothesis
Centres implementing a standard stipend and accommodation package will reduce treatment abandonment in paediatric ALL and Hodgkin lymphoma below 5% from baselines often above 20%, with a cost per additional cure under $2,000.
Rationale
Conditional cash transfers have strong evidence for adherence in TB and HIV; abandonment data from paediatric oncology programmes show large effects from modest support.
What would test it
Stepped introduction across a national paediatric network with abandonment rate, event-free survival, and cost per averted abandonment as endpoints.
Maturity
being tested at scale
Who has to act
philanthropy
Cost to try
Small (under $1M)
Years to first evidence
2
Bottlenecks it attacks

Connected

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