Progress update: Palliative care development between 2017 and 2020 in five African countries

Purpose Despite increased access to palliative care in Africa, there remains substantial unmet need. We examined the impact of approaches to promoting the development of palliative care in two African countries, Uganda and Kenya, and considered how these and other strategies could be applied more broadly. Methods This study reviews published data on development approaches to palliative care in Uganda and Kenya across five domains: education and training, access to opioids, public and professional attitudes, integration into national health systems, and research. These countries were chosen because they are African leaders in palliative care, in which successful approaches to palliative care development have been used. Results Both countries have implemented strategies across all five domains to develop palliative care. In both countries, successes in these endeavors seem to be related to efforts to integrate palliative care into the national health system and educational curricula, the training of health care providers in opioid treatment, and the inclusion of community providers in palliative care planning and implementation. Research in palliative care is the least well-developed domain in both countries. Conclusion A multidimensional approach to development of palliative care across all domains, with concerted action at the policy, provider, and community level, can improve access to palliative care in African countries.

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Palliative Care Development: The Nepal Model

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2007.02.009 ◽

2007 ◽

Vol 33 (5) ◽

pp. 573-577 ◽

Cited By ~ 6

Author(s):

Stuart Brown ◽

Fraser Black ◽

Pradeep Vaidya ◽

Sudip Shrestha ◽

Doug Ennals ◽

...

Keyword(s):

Palliative Care ◽

Care Development

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Palliative care development in Asia Pacific region: A review of assessment indicators

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2021.04.017 ◽

2021 ◽

Author(s):

Associate Professor and Director Megan F. Liu ◽

Mu-Hsing Ho ◽

Senior Lecturer Jed Montayre ◽

Director-General Ying-Wei Wang ◽

Head and Professor Chia-Chin Lin

Keyword(s):

Palliative Care ◽

Asia Pacific ◽

Pacific Region ◽

Asia Pacific Region ◽

Care Development

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Palliative Care Development in Kyrgyzstan

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2017.05.010 ◽

2018 ◽

Vol 55 (2) ◽

pp. S41-S45

Author(s):

Aibek Mukambetov ◽

Taalaigul Sabyrbekova ◽

Lola Asanalieva ◽

Ilim Sadykov ◽

Stephen R. Connor

Keyword(s):

Palliative Care ◽

Care Development

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Recalibrating the ‘world map’ of palliative care development

Wellcome Open Research ◽

10.12688/wellcomeopenres.15109.1 ◽

2019 ◽

Vol 4 ◽

pp. 77

Author(s):

Nicole Baur ◽

Carlos Centeno ◽

Eduardo Garralda ◽

Stephen Connor ◽

David Clark

Keyword(s):

Palliative Care ◽

End Of Life ◽

Grey Literature ◽

Primary Data ◽

Online Questionnaire ◽

Documentary Sources ◽

European Languages ◽

Data Limitations ◽

The University ◽

Care Development

Background: Despite growing interest from policy makers, researchers and activists in the global development of palliative care, there is still little science to underpin it. This study presents the methods deployed in the creation of a ‘world map’ of palliative care development. Building on two previous iterations, with improved rigour and taking into account reviewers’ feedback, the aim of this recalibrated version of the study is to determine the level of palliative care development in 198 United Nations recognised countries in 2017, whilst ensuring comparability with previous versions. We present methods of data collection and analysis. Methods and analysis: Primary data on the level of palliative care development in 2017 was collected from in-country experts through an online questionnaire and, where required, supplemented by published documentary sources and grey literature. Data relating to the total population of each country as well as per capita opioid consumption were derived from independent sources. Data analysis was conducted according to a new scoring system and algorithm developed by the research team. Ethics and dissemination: The study was approved by the University of Glasgow College of Social Sciences Research Ethics Committee. Findings of the study will be disseminated in peer-reviewed journals, as a contribution to the second edition of the Global Atlas of Palliative Care at the End-of-Life, and via social media, including the Glasgow End of Life Studies Group blog and the project website. Limitations of the study: There are potential biases associated with self-reporting by key in-country experts. In some countries, the identified key expert failed to complete the questionnaire in whole or part and data limitations were potentially compounded by language restrictions, as questionnaires were available only in three European languages. The study relied in part on data from independent sources, the accuracy of these data could not be verified.

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ANTIBIOTIC STEWARDSHIP IN PALLIATIVE CARE — DEVELOPMENT OF ANTIBIOTIC PRESCRIBING GUIDELINES FOR A HOSPICE INPATIENT UNIT

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2014-000654.177 ◽

2014 ◽

Vol 4 (Suppl 1) ◽

pp. A62.3-A63

Author(s):

Leila Donald ◽

Fiona Lindsay

Keyword(s):

Palliative Care ◽

Antibiotic Stewardship ◽

Inpatient Unit ◽

Antibiotic Prescribing ◽

Care Development

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Facts and indicators on palliative care development in 52 countries of the WHO European region: results of an EAPC task force

Palliative Medicine ◽

10.1177/0269216307081942 ◽

2007 ◽

Vol 21 (6) ◽

pp. 463-471 ◽

Cited By ~ 81

Author(s):

Carlos Centeno ◽

David Clark ◽

Thomas Lynch ◽

Javier Racafort ◽

David Praill ◽

...

Keyword(s):

Palliative Care ◽

Task Force ◽

European Region ◽

Care Development

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Factors Affecting Palliative Care Development in Africa: In-Country Experts' Perceptions in Seven Countries

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2018.01.009 ◽

2018 ◽

Vol 55 (5) ◽

pp. 1313-1320.e2 ◽

Cited By ~ 6

Author(s):

John Y. Rhee ◽

Eduardo Garralda ◽

Eve Namisango ◽

Emmanuel Luyirika ◽

Liliana de Lima ◽

...

Keyword(s):

Palliative Care ◽

Factors Affecting ◽

Care Development

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The WHO Collaborating Centre for Public Health Palliative Care Programs: An Innovative Approach of Palliative Care Development

Journal of Palliative Medicine ◽

10.1089/jpm.2013.0203 ◽

2014 ◽

Vol 17 (4) ◽

pp. 385-392 ◽

Cited By ~ 6

Author(s):

Sara Ela ◽

Jose Espinosa ◽

Marisa Martínez-Muñoz ◽

Cristina Lasmarías ◽

Elba Beas ◽

...

Keyword(s):

Public Health ◽

Palliative Care ◽

Innovative Approach ◽

Care Development

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Using a supportive care framework to understand and improve palliative care among cancer patients in Africa

Palliative & Supportive Care ◽

10.1017/s1478951515000796 ◽

2015 ◽

Vol 14 (3) ◽

pp. 284-301 ◽

Cited By ~ 4

Author(s):

David S. Busolo ◽

Roberta L. Woodgate

Keyword(s):

Palliative Care ◽

Supportive Care ◽

Cancer Patients ◽

Care Needs ◽

African Countries ◽

Research Education ◽

Patients With Cancer ◽

Care Services ◽

Incidence And Mortality ◽

Palliative Care Services

ABSTRACTObjective:Cancer incidence and mortality are increasing in Africa, which is leading to greater demands for palliative care. There has been little progress in terms of research, pain management, and policies related to palliative care. Palliative care in Africa is scarce and scattered, with most African nations lacking the basic services. To address these needs, a guiding framework that identifies care needs and directs palliative care services could be utilized. Therefore, using the supportive care framework developed by Fitch (Fitch, 2009), we here review the literature on palliative care for patients diagnosed with cancer in Africa and make recommendations for improvement.Method:The PubMed, Scopus, CINAHL, Web of Science, Embase, PsycINFO, Social Sciences Citation Index, and Medline databases were searched. Some 25 English articles on research from African countries published between 2004 and 2014 were selected and reviewed. The reviewed literature was analyzed and presented using the domains of the supportive care framework.Results:Palliative care patients with cancer in Africa, their families, and caregivers experience increasing psychological, physical, social, spiritual, emotional, informational, and practical needs. Care needs are often inadequately addressed because of a lack of awareness as well as deficient and scattered palliative care services and resources. In addition, there is sparse research, education, and policies that address the dire situation in palliative care.Significance of Results:Our review findings add to the existing body of knowledge demonstrating that palliative care patients with cancer in Africa experience disturbing care needs in all domains of the supportive care framework. To better assess and address these needs, holistic palliative care that is multidomain and multi-professional could be utilized. This approach needs to be individualized and to offer better access to services and information. In addition, research, education, and policies around palliative care for cancer patients in Africa could be more comprehensive if they were based on the domains of the supportive care framework.

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