Challenges and Considerations in Transitioning from Cobalt-60 to Linear Accelerators for Radiotherapy in LMICs Healthcare Settings: A Case Study of Nepal.

<ns3:p>Nepal's move from Cobalt-60 machines to modern linear accelerators in radiation therapy presents significant challenges. Infrastructure limitations demand substantial investments for facility upgrades, particularly in retrofitting existing cobalt-60 bunkers and ensuring stable power supplies. The scarcity of skilled personnel underscores the need for comprehensive education initiatives and international collaborations. Regulatory compliance requires the establishment of robust frameworks, emphasizing the urgency of an independent regulatory authority. Collaborations with international institutions offer expertise and resources crucial for capacity building. Financial constraints necessitate innovative financing models to mitigate procurement and maintenance costs. Unforeseen circumstances, exemplified by the Covid-19 pandemic, highlight the importance of adaptability in implementation strategies. Despite challenges, Nepal's transition signifies an opportunity to enhance cancer care, emphasizing the need for a tailored, multidimensional approach addressing infrastructure, workforce, regulatory, financial, and collaborative aspects.</ns3:p>