Before putting in place a unit, it is nec essary to ensure that this activity will be large enough to allow the team to acquire appropriate experience. To do this, 50 new cancer cases per year appear to be a minimum to develop sufficient expertise and form a reliable tertiary care facility for children with cancer. Therefore, it is necessary to have an estimation of epidemiology of childhood cancer in the serving area. There must also be a commitment from the health authorities, and if possible, non governmental organizations (NGOs) to support this activity through the provision of minimal required resources.

Human resources must be adapted to the expected activity. The health care team must include full-time doctors and nurses trained in pediatric oncology. The team should be able to meet the demand for urgent situations as well as planned activity.

Physicians should be trained in clinical oncology in children, in prescription and monitoring of chemotherapy and in supportive care. Nurses must also be trained in pediatric oncology, in the preparation and administration of chemotherapy and supportive care. The training should address theoretical and practical issues.

It is important to have in the team a social worker, psychologist, physiotherapist, and nutritionist.

The pediatric oncology unit can be in a children’s hospital (preferably), in an oncology or a hematology centre. In cases where the pediatric oncology unit is outside a children’s hospital, it is important to ensure easy access to intensive care unit, radiology, and laboratory. The best location for a pedaitric oncology unit is in a university hospital in order to contribute to the training of young doctors and nurses in that specialty. The unit should be organized in subunits including inpatient unit , a day care unit , and an outpatient clinic.

The inpatient ward should have at least 8–10 beds and be sufficiently large to avoid the crowding of patients and parents. It should be separated from units for patients with other conditions that may constitute a risk of infection for children undergoing chemotherapy. The hospital should strive on offering the possibility of hosting one of the parents if the child or his parents wish so. In Africa, special attention should be given to hygiene requirements (Fig. 4.1).

Day care unit should be put in place because in the majority of cases, initial evaluation, treatment with chemotherapy or supportive care does not require inpatient admission (Fig. 4.2). This reduces the risks associated with hospitalization and also costs and also helps to maintain the child in his family environment.

It is also important to have an intensive care unit for children within the department or within the hospital where children can be admitted.

The hospital should have resources for diagnosis and prognosis needed for patient’s evaluation. These resources must be adapted to specific needs of cancers in children.

Clinical laboratory is of critical importance for appropriate care.