Abstract Background Pediatric central nervous system (CNS) tumor care is complex and resource-intensive. In low-income countries, a systematic assessment of service capacity is essential to identify gaps and prioritize interventions that improve care. The PANORAMA (PediAtric Neuro-Oncology Resources AssessMent Aid) tool was developed to evaluate pediatric neuro-oncology services. This study sought to evaluate the capacity and identify gaps in pediatric neuro-oncology services at two collaborating hospitals in Uganda: Uganda Cancer Institute (UCI) and Cure Children’s Hospital of Uganda (CCHU). Methods A cross-sectional, facility-based assessment was conducted using the PANORAMA tool, comprising quantitative and qualitative items across 13 domains. Data collection involved a local assessor at UCI completing a structured electronic survey in REDCap. Quantitative responses were analyzed using a predefined scoring algorithm, with domain performance rated as A (≥80%), B (60–79%), or C (60%). Results UCI demonstrated strong infrastructure with A-rated performance in National Context (80%), Hospital Profile (86%), Organization Chemotherapy scored 53% (C) with no standardized protocols or targeted therapies.There were critical deficits in specialized staffing. Conclusion While the UCI/CCHU collaboration has a strong foundation, critical gaps remain in pathology, precision diagnostics, and protocolized treatment. Priority areas for intervention include capacity-building in neuropathology, protocol standardization, specialist training, and improving access to radiotherapy. The PANORAMA tool, with its multi-dimensional gap analysis, provides an actionable framework for quality improvement in resource-variable settings. 1. Rajagopal R, Diaz-Coronado R, Hamid SA, et al. OTHR03. Development of PANORAMA: an assessment tool for pediatric neuro-oncology service delivery capacity. Neuro Oncol. 2024; doi:10.1093/neuonc/noae064.674.
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