Authors: Anu Savio Thelly, Tara Devi Laabar, Rizwana Hussain, Dr Spandana Rayala.
The Sunflower Children’s Network, an initiative of Two Worlds Cancer Collaboration, in partnership with the International Children’s Palliative Care Network (ICPCN) and the Global Palliative Nursing Network (GPNN), continues to strengthen global nursing capacity through its nurse-led Pediatric Palliative Care Nursing ECHO programme.
Following the success of its initial launch in October 2025, the second cohort of the Introductory Course in Pediatric Palliative Care brought together nurses from across Asia, Africa, and other low- and middle-income countries (LMICs), creating a vibrant and diverse learning community.
The course was delivered over eight weeks (February 2 to March 23, 2026) through eight interactive virtual sessions, each lasting 75 minutes. Sessions followed the ECHO model’s “All Teach, All Learn” approach, combining focused didactic teaching, engaging case-based discussions, and open Q&A to ensure learning remained practical, relevant, and directly applicable to LMIC settings.
Participants joined from 36 countries, including: India, Indonesia, Pakistan, Bangladesh, Nepal, Sri Lanka, Philippines, Vietnam, Thailand, Malaysia, Myanmar, Cambodia, Oman, United Arab Emirates, Saudi Arabia, Qatar, Jordan, Lebanon, Iran, Iraq, Afghanistan, Ghana, Kenya, Nigeria, Uganda, Tanzania, Ethiopia, South Africa, Rwanda, Malawi, Zambia, Zimbabwe, Sierra Leone, Cameroon, Sudan, and Egypt.
Participants represented a wide geographic spread, with strong engagement from Asia (approx. 140 registrations) and Africa (approx. 70 registrations). Countries such as India, Ghana, Kenya, Oman, and Indonesia showed particularly high participation, and Ghana and Kenya, in particular, demonstrated strong completion rates, highlighting meaningful engagement in resource-limited settings. 117 nurses met the attendance and post-course assessment requirements and are successfully certified.
The programme was enriched by expert global faculty, bringing diverse perspectives and real-world experience in pediatric palliative care. Beyond knowledge sharing, the sessions created a safe and supportive space where nurses could openly discuss challenges, reflect on difficult situations, and learn from each other’s experiences.
A key innovation in this cohort was the introduction of a trial session prior to the programme, conducted in collaboration with the iECHO technical team from India. This session supported participants with registration and platform navigation, and provided valuable insights into the technological barriers faced by nurses in LMICs, including connectivity issues, and unfamiliarity with digital platforms.
A nearly 40% drop-off occurred during onboarding, suggesting that access-related challenges—rather than a lack of interest—remain a significant barrier. In addition, recent geopolitical disruptions may have further affected participation and continuity for some
nurses. Importantly, the technical team observed that the programme is not only building clinical capacity but also strengthening nurses’ digital skills and confidence, an essential component of equitable global learning.
To sustain engagement beyond the sessions, participants were connected through a WhatsApp community, creating an ongoing space for peer support, experience sharing, challenge discussion, and feedback exchange. This sense of connection helped extend learning beyond the virtual classroom and fostered a growing global network of pediatric palliative care nurses.
In parallel, a Pediatric Palliative Care Nursing Education Needs Assessment Survey was administered to better understand nurses’ learning needs and priorities. The response is highly encouraging, with many participants expressing a strong desire for continued learning, mentorship, and advanced training opportunities.
This cohort reaffirmed that when learning is made accessible, relevant, and supportive, nurses across LMICs are eager to engage, grow, and lead change in pediatric palliative care.
Encouraged by this response, the next cohort commenced on April 9, 2026, continuing the journey of building a global community of practice.
We also shared our experience and reflections from the first cohort at IAPCON 2026 in Hyderabad (February), contributing to wider learning and dialogue in pediatric palliative care.
More than a training programme, the Sunflower ECHO series is evolving into a shared space for connection, confidence, and collective learning—strengthening nurses’ capacity to provide compassionate, high-quality care to children and their families, wherever they are.
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