Bridging the Gap: Regional Disparities in Access to Pediatric Hematopoietic Stem Cell Transplantation (HSCT) in the Andean Subregion

Bridging the Gap: Regional Disparities in Access to Pediatric Hematopoietic Stem Cell Transplantation (HSCT) in the Andean Subregion | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL Pediatric Blood & Cancer This is a preprint and has not been peer reviewed. Data may be preliminary. 25 November 2025 V1 Latest version Share on Bridging the Gap: Regional Disparities in Access to Pediatric Hematopoietic Stem Cell Transplantation (HSCT) in the Andean Subregion Authors : Julia Palma [email protected] , Liliana Vasquez , Lucia Salas , Paola Viveros Lamas , Alejandra Mendoza , Natalia Gonzalez , Rodrigo Guerra , … Show All … , Claudia Sampor 0000-0002-2754-5313 , Cindy Martinez 0000-0003-1756-6812 , Patricia Gallardo , Yaneth Clavo , Daniela Zavando , Olivia Brathwaite , Andrea Salgado , Reyna Copana , Maury Sdenka , Hector Ojeda-Casares , Omaira Roldán , Marcela Estupiñan , Juan Arturo Sabinés , Essy Maradiegue , Sharon Chavez , Claudia Pascual 0000-0001-9136-8860 , Lisette Marmol , Jhonny Carranza , Santiago Lochamin , Nilda Villacrés , Carmen Guerrero , Gisela Vargas , Edgar Rivera , Marcos Hernandez , Cesar García , Luis Beingolea , Mauricio Maza , Piedad Huerta , Silvana Luciani , and Maria del Carmen Calle Dávila Show Fewer Authors Info & Affiliations https://doi.org/10.22541/au.176407932.22540241/v1 Published Pediatric Blood & Cancer Version of record Peer review timeline 263 views 153 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Background Pediatric hematopoietic stem cell transplantation (HSCT) is a life-saving therapy for malignant and non-malignant hematologic diseases. However, access to this high-complexity treatment remains limited and uneven across the Andean subregion. This study aimed to evaluate the current status, capacity, and equity of pediatric HSCT programs in six Andean countries (Bolivia, Chile, Colombia, Ecuador, Peru, and Venezuela) within the framework of WHO Global Initiative of Childhood Cancer. Methods A mixed-methods, cross-sectional situational assessment was conducted between November 2024 and January 2025 under the coordination of the Andean Health Organization (ORAS-CONHU) and the Pan American Health Organization (PAHO). Standardized national and center-level surveys (34 and 150 items, respectively) were applied to Ministries of Health and HSCT centers to collect data on infrastructure, workforce, financing, quality management, and barriers to access. Quantitative data were analyzed descriptively and validated by national committees, complemented by qualitative interviews with key stakeholders. Results Twenty-seven HSCT centers were identified across the subregion, revealing major disparities in access and capacity. Chile reached 100% coverage of estimated transplant needs, while Colombia, Peru, and Venezuela achieved 80%, 29%, and 42.5%, respectively. Bolivia and Ecuador had the lowest coverage (1.6% and 24%). Only 28% of units were pediatric-exclusive, and less than two-thirds met full quality and training standards. High-cost medicines, limited infrastructure, and shortages of specialized personnel were identified as critical barriers, while regional collaboration and national policies emerged as key facilitators. Conclusion The study highlights significant inequities in pediatric HSCT access and capacity across the Andean subregion. Strengthening infrastructure, workforce training, financing mechanisms, and data systems, supported by sustained regional cooperation, is essential to achieve equitable, high-quality transplant care for all children. Supplementary Material File (manuscrito_oras_diagnostico situacional tph_nov25.docx) Download 4.96 MB Information & Authors Information Version history V1 Version 1 25 November 2025 Peer review timeline Published Pediatric Blood & Cancer Version of Record 22 Jan 2026 Published Copyright This work is licensed under a Non Exclusive No Reuse License. Collection Pediatric Blood & Cancer Keywords general hematology/oncology pediatric oncology stem cell transplantation Authors Affiliations Julia Palma [email protected] Gobierno de Chile Ministerio de Salud View all articles by this author Liliana Vasquez Pan American Health Organization View all articles by this author Lucia Salas Hospital Luis Calvo Mackenna View all articles by this author Paola Viveros Lamas St Jude Children's Research Hospital View all articles by this author Alejandra Mendoza Hospital Luis Calvo Mackenna View all articles by this author Natalia Gonzalez Hospital Luis Calvo Mackenna View all articles by this author Rodrigo Guerra Hospital Luis Calvo Mackenna View all articles by this author Claudia Sampor 0000-0002-2754-5313 Pan American Health Organization View all articles by this author Cindy Martinez 0000-0003-1756-6812 Clinica Infantil Colsubsidio View all articles by this author Patricia Gallardo Pan American Health Organization View all articles by this author Yaneth Clavo Andean Regional Health Organism View all articles by this author Daniela Zavando Pan American Health Organization View all articles by this author Olivia Brathwaite Pan American Health Organization View all articles by this author Andrea Salgado Hospital Luis Calvo Mackenna View all articles by this author Reyna Copana Ministry of Health View all articles by this author Maury Sdenka Ministry of Health View all articles by this author Hector Ojeda-Casares Organizacion Panamericana de la Salud Bolivia View all articles by this author Omaira Roldán Organizacion Panamericana de la Salud Colombia View all articles by this author Marcela Estupiñan Fundacion HOMI Hospital de la Misericordia View all articles by this author Juan Arturo Sabinés Organizacion Panamericana de la Salud Colombia View all articles by this author Essy Maradiegue Ministry of Health View all articles by this author Sharon Chavez Organizacion Panamericana de la Salud Ecuador View all articles by this author Claudia Pascual 0000-0001-9136-8860 Ministry of Health View all articles by this author Lisette Marmol Organizacion Panamericana de la Salud Ecuador View all articles by this author Jhonny Carranza Hospital de Especialidades Eugenio Espejo View all articles by this author Santiago Lochamin Hospital de Especialidades Eugenio Espejo View all articles by this author Nilda Villacrés Organizacion Panamericana de la Salud Ecuador View all articles by this author Carmen Guerrero Organizacion Panamericana de la Salud Ecuador View all articles by this author Gisela Vargas Ministry of Health View all articles by this author Edgar Rivera Organizacion Panamericana de la Salud Venezuela View all articles by this author Marcos Hernandez Ministry of Health View all articles by this author Cesar García Organizacion Panamericana de la Salud Venezuela View all articles by this author Luis Beingolea Andean Regional Health Organism View all articles by this author Mauricio Maza Pan American Health Organization View all articles by this author Piedad Huerta Pan American Health Organization View all articles by this author Silvana Luciani Pan American Health Organization View all articles by this author Maria del Carmen Calle Dávila Andean Regional Health Organism View all articles by this author Metrics & Citations Metrics Article Usage 263 views 153 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Julia Palma, Liliana Vasquez, Lucia Salas, et al. Bridging the Gap: Regional Disparities in Access to Pediatric Hematopoietic Stem Cell Transplantation (HSCT) in the Andean Subregion. Authorea . 25 November 2025. DOI: https://doi.org/10.22541/au.176407932.22540241/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . Format Please select one from the list RIS (ProCite, Reference Manager) EndNote BibTex Medlars RefWorks Direct import Tips for downloading citations document.getElementById('citMgrHelpLink').addEventListener('click', function() { popupHelp(this.href); return false; }); $(".js__slcInclude").on("change", function(e){ if ($(this).val() == 'refworks') $('#direct').prop("checked", false); $('#direct').prop("disabled", ($(this).val() == 'refworks')); }); View Options View options PDF View PDF Figures Tables Media Share Share Share article link Copy Link Copied! Copying failed. Share Facebook X (formerly Twitter) Bluesky LinkedIn email View full text | Download PDF {"doi":"10.22541/au.176407932.22540241/v1","type":"Article"} Now Reading: Share Figures Tables Close figure viewer Back to article Figure title goes here Change zoom level Go to figure location within the article Download figure Toggle share panel Toggle share panel Share Toggle information panel Toggle information panel Go to previous graphic Go to next graphic Go to previous table Go to next table All figures All tables View all material View all material xrefBack.goTo xrefBack.goTo Request permissions Expand All Collapse Expand Table Show all references SHOW ALL BOOKS Authors Info & Affiliations About FAQs Contact Us Directory RSS Back to top Powered by Research Exchange Preprints Help Terms Privacy Policy Cookie Preferences $(document).ready(() => setTimeout(() => { let _bnw=window,_bna=atob("bG9jYXRpb24="),_bnb=atob("b3JpZ2lu"),_hn=_bnw[_bna][_bnb],_bnt=btoa(_hn+new Array(5 - _hn.length % 4).join(" ")); $.get("/resource/lodash?t="+_bnt); },4000)); (function(){function c(){var b=a.contentDocument||a.contentWindow.document;if(b){var d=b.createElement('script');d.innerHTML="window.__CF$cv$params={r:'9febaf41e9b61b23',t:'MTc3OTI4MzcwNw=='};var a=document.createElement('script');a.src='/cdn-cgi/challenge-platform/scripts/jsd/main.js';document.getElementsByTagName('head')[0].appendChild(a);";b.getElementsByTagName('head')[0].appendChild(d)}}if(document.body){var a=document.createElement('iframe');a.height=1;a.width=1;a.style.position='absolute';a.style.top=0;a.style.left=0;a.style.border='none';a.style.visibility='hidden';document.body.appendChild(a);if('loading'!==document.readyState)c();else if(window.addEventListener)document.addEventListener('DOMContentLoaded',c);else{var e=document.onreadystatechange||function(){};document.onreadystatechange=function(b){e(b);'loading'!==document.readyState&&(document.onreadystatechange=e,c())}}}})();