Diagnostic imaging services offered in modern medical settings have evolved enormously in recent decades, but even state of the art healthcare can overlook the specificities of pediatric imaging. Imaging children requires understanding the unique needs of the patient and family. A child is not a small adult; knowledge of illnesses and medical conditions specific to the pediatric population is a necessity. Equipment, procedures and staff need to be oriented to the special needs of children. Radiation safety, in particular, needs to be specifically addressed in this young population. Subspecialty training in pediatric radiology requires years of medical school, residency and fellowship – requirements which can impose a strain on the world’s most advanced care centres.
Furthermore, organizations dedicated to pediatric imaging around the world need to communicate better among themselves, share knowledge and resources, and federate at international level to advocate for best practices and resource allocation.
While medical practice would suggest that around 80% of diagnostic problems can be solved using "basic" radiographic and/or ultrasound examinations, the WHO nonetheless reports that some two-thirds1 of the world’s population has inadequate or no access to medical imaging. It has defined technological availability as one of the world’s major health infrastructure needs. Clinicians face many challenges in providing pediatric imaging services in low-resource settings: cost, access, a massive disease burden, climate, geographical dispersion, political instability and a lack of equipment, infrastructure and manpower. In human resources terms alone, 14 countries in Africa have no radiologists at all, and most have less than 30 2. Zambia, for example, offers 4 public sector radiologists for an estimated population of just over 14.4 million (of which 47% is under 15 years of age)3 . Rarer still is the facility offering a pediatric radiologist; for the entire African continent, only a handful exist4. These difficulties are compounded by the need to allocate scarce resources to basic life-saving issues such as the supply of safe, clean water and nutrition. Appropriate policies for diagnostic imaging services are thus rarely integrated into national health plans and viewed as a priority. Health authorities are simply unaware of the live-saving diagnostic tools; they are therefore unavailable.
In 2011, the leaders of the world’s regional pediatric imaging societies launched the World Federation of Pediatric Imaging (WFPI), a non-political, non-denominational and non-discriminatory organization operating for exclusively non-profit, educational, scientific, research and outreach purposes. By 2012, after extensive cross-regional consultation, two firmly held convictions – the need for a louder pediatric voice in the imaging arena, and strength lies in numbers – led to a mission statement: “WFPI provides an international platform for pediatric radiology organizations united to address the challenges in global pediatric imaging training and the delivery of services.” Setting up its governing body in 20125 , WFPI went on to prioritize “Communication and collaboration between pediatric imaging practitioners, via their organizations” in its initial Strategic Framework (2012-20156 ) to achieve its goals. With limited resources and a loose working mandate, WFPI set about carving its niche, drawing heavily on those among its members with developing world experience.
In 2016, after a review of its first five years7 , WFPI incorporated the priorities and concerns expressed by its membership into its working priorities and planned development, as expressed in this revised Strategic Framework (2016 – 2021).
Structure and governance
The WFPI is composed of pediatric imaging organizations and its governing Council includes representation from North America, Europe, South America, Asia-Pacific and Africa8 . To ensure the WFPI’s global span, it is open to other regional societies and national and supranational organizations, whether pediatric imaging-centered (“full” members) or radiology organizations with pediatric sections/special interest groups and organizations for all professions related to medical imaging (“associate”, non-voting, members). Together, the WFPI’s members offer extensive international reach in terms of access to educational platforms, meetings, conferences, training courses, publications, contacts and networks.
It bears noting that WFPI is far from alone with its international goals. A number of non-profit imaging organizations and intrinsic international imaging efforts roll out in parallel, many pre-dating WFPI. The Rwanda ultrasound courses supported by the Société Francophone d'Imagerie Pédiatrique, the Swaziland teaching visit run by the South African Society of Paediatric Imaging and the RSNA4 Visiting Professor Program are just three examples. Institutions can run international pediatric imaging initiatives too – among others, Graz University Hospital, Austria, teaches in Eastern Europe, Toronto’s Hospital for Sick Children, Canada teaches in India, and the Children’s Hospital of Philadelphia (CHOP), USA offers a series of webinars in South Africa, in collaboration with the Radiological Society of South Africa and the South African Society of Paediatric Imaging. With its own resource limitations, WFPI cannot run such projects itself – but it embraces and supports the work of others and strives to ensure that resources are harnessed as opposed to duplicated.
 World Health Organization. Essential diagnostic imaging. Available at: www.who.int/eht/en/DiagnosticImaging.pdf
Accessed January 1, 2011.
 Andronikou S, McHugh K, Abdurahman N, Jkoury Bn Mngomezulu V, Brant W, Cowan I, McCulloch M, Ford N (2011) Paediatric radiology seen from Africa. Part I: providing diagnostic imaging to a young population Pediatr Radiol 41:811-825
 RAD-AID Country Reports, Zambia http://www.rad-aid.org/resource-center/country-reports/
Andronikou S (2014) Unique Issues in Africa - Society for Pediatric Radiology http://
 Bylaws - http://www.wfpiweb.org/Portals/7/About/FINAL_WFPI_Bylaws_revised_April2015.pdf
 WFPI Strategic Framework 2012 - 2015 http://www.wfpiweb.org/Portals/7/About/WFPI_Strategic%20Framework%20_Full_version.pdf
 Saving the Starfish: World Federation of Pediatric Imaging (WFPI) development, work to date, and membership feedback on international outreach, http://www.ncbi.nlm.nih.gov/pubmed/26994001
 Founding societies: the Society for Pediatric Radiology, the European Society of Pediatric Radiology, the Latin American Society of Pediatric Radiology, the Asian and Oceanic Society for Pediatric Radiology. Joined later : the African Society of Pediatric Imaging.
 Supranational organizations are built up on linguistic or other, non-geographical criteria. E.G. Europe’s German-speaking pediatric radiology society (GPR) which draws members from Germany, Austria, Switzerland and the Netherlands.