The rapid expansion of radiotherapy services in Ethiopia has underscored the critical need for a standardized, national framework to monitor, report, and learn from incidents in clinical practice. In response, we have developed a web-based National Incident Learning System (NILS) tailored to the specific needs and resource settings of Ethiopian radiotherapy centers.

The system is designed to facilitate the confidential reporting of incidents and near misses across all radiotherapy departments nationwide. Built with a user-friendly interface, it supports comprehensive data entry, classification, and analysis based on internationally recognized standards, including those recommended by the International Atomic Energy Agency (IAEA) and the World Health Organization (WHO). Key features include customizable incident categories, root cause analysis tools, corrective action tracking, and automated report generation for continuous quality improvement initiatives.

The development process involved close collaboration with Ethiopian radiation oncology professionals, medical physicists, and technologists to ensure local relevance and sustainable implementation. Pilot testing was conducted across three major radiotherapy centers, demonstrating the system’s effectiveness in improving incident reporting culture and facilitating the identification of systemic issues affecting patient safety.

This project represents a significant step toward strengthening the national radiation safety infrastructure and fostering a culture of learning and transparency in Ethiopian radiotherapy services. The lessons learned during development and early deployment may provide valuable insights for other low- and middle-income countries seeking to establish similar national incident learning frameworks.