scholarly journals The Integration of Palliative Care in DR Congo “A Model Of Sustainability”: A Field Study

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 171s-171s
Author(s):  
A. Mubeneshayi Kananga
Keyword(s):  
Palliative Care ◽  
Health System ◽  
Capacity Building ◽  
Family Involvement ◽  
Health Professionals ◽  
Terminal Phase ◽  
National Guidelines ◽  
Dr Congo ◽  
Ministry Of Health ◽  
International Colloquium

Background and context: In DR Congo, many cancer patients in the terminal phase of their condition have minimal access to palliative care. There is a combined effect of poverty, the deterioration of the health system and the absence of a well-defined national policy on palliative care. Patients are for the most part abandoned to the care of inexperienced family members. Driven by the fact that the number of palliative patients has been increasing steadily over the past five years, the Palliafamilli association and its partners have taken leadership in the fight for palliative care. The major issue that blocks palliative care in RD Congo is the lack of knowledge about palliative care both in the population and even in health professionals. Most patients are treated at home with strong family involvement in many aspects of care. Aim: To promote good health practices at the community level and equip them with the knowledge and means to prevent their health problems, with a focus on palliative care and to contribute to the implementation of the Strategy for Strengthening the Health System of DR Congo by facilitating a program of access to palliative care for the entire Congolese population. Strategy/Tactics: During the last 7 years, we have organized conferences, congresses, various training sessions on pain management, sensitization activities, capacity building courses and advocacy activities within the Ministry of Health for national palliative care guidelines. Program/Policy process: - The organization of two International Congress of Palliative Care in Kinshasa in April 2013 (550 participants) and September 2015 (700 participants) - Training of 3 health professionals on the palliative approach in Uganda (2013) - Participation at the Second Francophone Palliative Care Congress in Montreal 2013 - A palliative care training course at the University of Kinshasa in 2015 (115 participants) - The organization of the International Colloquium of Pediatric Palliative Care in Kinshasa in 2015 - Participation in the 4th International Francophone Congress of Palliative Care in Geneva (2017) - Participating in the drafting of national guidelines for palliative care within the Ministry of Health (2017) - Capacity building for two members of PalliaFamilli thanks to the scholarship offered by the UICC. What was learned: In DR Congo, palliative care and pain relief require a cross-cutting approach, as resources are limited, many people are in need of care, and there are few nurses and doctors empowered to provide care. An effective approach is to involve community or volunteer caregivers supervised by health professionals, and Palliafamilli is successful due in its multidisciplinary and multisectoral approach, with adaptation to cultural, social and economic specificities and its integration with existing health systems, focusing on primary health care and community and home care.

scholarly journals Coordination of Care Within a Mobile Palliative Care Team and Organization of a Continuing Education Program for Health Professionals in Palliative Care

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 62s-62s
Author(s):  
A. Mubeneshayi Kananga
Keyword(s):  
Palliative Care ◽  
Best Practices ◽  
Continuing Education ◽  
Health Professionals ◽  
National Policy ◽  
Palliative Care Team ◽  
Care Team ◽  
Terminal Phase ◽  
Dr Congo ◽  
Mobile Team

Background: In DR Congo (DRC), many cancer patients in the terminal phase of their condition have minimal access to palliative care. There is a combined effect of poverty, the deterioration of the health system and the absence of a well-defined national policy on palliative care. Patients are for the most part abandoned to the care of inexperienced family members. Founded in 2009, Palliafamilli aims to improve the quality of life of patients requiring palliative care in the DRC by providing visits and care for patients, by striving to increase access to palliative care in the region and by informing, raising awareness and mobilizing key national stakeholders. In September 2018, Palliafamilli will launch a mobile palliative care team (MPCT) in partnership with the general hospital of Ndjili in Kinshasa. The MPCT is an interdisciplinary team consisting of physicians, nurses, a psychologist and a project manager; all experienced in accompaniment, symptom management and palliative emergency. It has a consultancy role for professionals, patients and their caregivers. Aim: Through a African Cancer Fellowship award, I will visit a mobile team of palliative care from CHRU Besançon, France, for one month in May 2018 to gain experience in designing and implementing best practices for a mobile palliative care team. Methods: I will work closely with the mobile palliative care team of the Besançon Regional Hospital Center to gain experience regarding the coordination and care administration of palliative care within a mobile team. I will also learn about the different programs of continuing education for health professionals, make comparisons and adapt the programs to the reality of DR Congo. Results: With a view to promoting access to palliative care patients, I intend to learn from the host organization the best practices that they apply to overcome communication difficulties with the patient and their relatives which can constitute delays to access to adequate care. This delay is more marked for patients suffering from cancer because the evolution of their pathology is unpredictable. The main barriers are the insufficient knowledge of patients' needs and the opportunities offered by palliative care. Upon my return, I will adapt the best practices learned in France to the DRC context during the launch of the new mobile palliative care team. Conclusion: In Congo, a cross-cutting approach is required to provide patients with palliative care and pain relief, as resources are limited, many people are in need of care, and there are few nurses and doctors empowered to provide care. An effective approach is to involve community or volunteer caregivers supervised by health professionals, and Palliafamilli is successful due in its multidisciplinary and multisectoral approach, with adaptation to cultural, social and economic specificities and its integration with existing health systems, focusing on primary health care and community and home care.

Māori Research(er) in Three Poems

2018 ◽  
Vol 2 (1) ◽  
pp. 35
Author(s):  
Jacquie Kidd
Keyword(s):  
Palliative Care ◽  
Health Literacy ◽  
Cultural Identity ◽  
Focus Groups ◽  
Health Professionals ◽  
Bell Hooks ◽  
Face To Face ◽  
The Third ◽  
Ruth Behar ◽  
Seeking Help

These three poems re-present the findings from a research project that took place in 2013 (Kidd et al. 2018, Kidd et al. 2014). The research explored what health literacy meant for Māori patients and whānau when they accessed palliative care. Through face-to-face interviews and focus groups we engaged with 81 people including patients, whānau, bereaved loved ones, support workers and health professionals. The poems are composite, written to bring some of our themes to life. The first poem is titled Aue. This is a Māori lament that aligns to English words such as ‘oh no’, or ‘arrgh’, or ‘awww’. Each stanza of the poem re-presents some of the stories we heard throughout the research. The second poem is called Tikanga. This is a Māori concept that encompasses customs, traditions and protocols. There are tikanga rituals and processes that guide all aspects of life, death, and relationships. This poem was inspired by an elderly man who explained that he would avoid seeking help from a hospice because ‘they leave tikanga at the door at those places’. His choice was to bear his pain bravely, with pride, within his cultural identity. The third poem is called ‘People Like Me’. This is an autoethnographical reflection of what I experienced as a researcher which draws on the work of scholars such as bell hooks (1984), Laurel Richardson (1997) and Ruth Behar (1996). These and many other authors encourage researchers to use frustration and anger to inform our writing; to use our tears to fuel our need to publish our research.

scholarly journals First catheter ablations in the Ministry of Health system of Peru: Report of the initial experience

2019 ◽  
Vol 24 ◽  
pp. 100402
Author(s):  
Raúl A. Montañez-Valverde ◽  
Luis Alberto More ◽  
Pablo Mendoza-Novoa
Keyword(s):  
Health System ◽  
Initial Experience ◽  
Ministry Of Health

Health system characteristics of quality care delivery: A comparative case study examination of palliative care for cancer patients in four regions in Ontario, Canada

2011 ◽  
Vol 26 (4) ◽  
pp. 322-335 ◽  
Author(s):  
Jonathan Sussman ◽  
Lisa Barbera ◽  
Daryl Bainbridge ◽  
Doris Howell ◽  
Jinghao Yang ◽  
...  
Keyword(s):  
Palliative Care ◽  
Health System ◽  
Acute Care ◽  
Pattern Analysis ◽  
Care Delivery ◽  
Quality Care ◽  
Structural Features ◽  
Comparative Case Study ◽  
Care Utilization

Background: A number of palliative care delivery models have been proposed to address the structural and process gaps in this care. However, the specific elements required to form competent systems are often vaguely described. Aim: The purpose of this study was to explore whether a set of modifiable health system factors could be identified that are associated with population palliative care outcomes, including less acute care use and more home deaths. Design: A comparative case study evaluation was conducted of ‘palliative care’ in four health regions in Ontario, Canada. Regions were selected as exemplars of high and low acute care utilization patterns, representing both urban and rural settings. A theory-based approach to data collection was taken using the System Competency Model, comprised of structural features known to be essential indicators of palliative care system performance. Key informants in each region completed study instruments. Data were summarized using qualitative techniques and an exploratory factor pattern analysis was completed. Results: 43 participants (10+ from each region) were recruited, representing clinical and administrative perspectives. Pattern analysis revealed six factors that discriminated between regions: overall palliative care planning and needs assessment; a common chart; standardized patient assessments; 24/7 palliative care team access; advanced practice nursing presence; and designated roles for the provision of palliative care services. Conclusions: The four palliative care regional ‘systems’ examined using our model were found to be in different stages of development. This research further informs health system planners on important features to incorporate into evolving palliative care systems.

scholarly journals The impact of the environment on patient experiences of hospital admissions in palliative care

2015 ◽  
Vol 8 (4) ◽  
pp. 485-492 ◽  
Author(s):  
Jackie Robinson ◽  
Merryn Gott ◽  
Clare Gardiner ◽  
Christine Ingleton
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Hospital Admissions ◽  
Hospital Setting ◽  
Prognostic Indicators ◽  
Care Needs ◽  
Acute Hospitals ◽  
Almost All ◽  
The Impact ◽  
Palliative Care Needs

ObjectiveTo explore the impact of environment on experiences of hospitalisation from the perspective of patient's with palliative care needs.MethodsA qualitative study design using longitudinal semistructured, face-to-face interviews were used to elicit the views of patients with palliative care needs admitted to hospital in 1 large urban acute hospital in New Zealand. The sample comprised of 14 patients admitted to hospital between July 2013 and March 2014 who met one of the Gold Standard Framework Prognostic Indicators for palliative care need.ResultsAlmost all participants described a range of factors associated with the environment which impacted negatively on their experiences of hospitalisation. This included challenges with the physical surroundings, the impact on social relationships with other patients, families and health professionals and the influence of the cultural milieu of the hospital setting.ConclusionsEmulating the ‘ideal’ environment for palliative care such as that provided in a hospice setting is an unrealistic goal for acute hospitals. Paying attention to the things that can be changed, such as enabling family to stay and improving the flexibility of the physical environment while improving the social interplay between patients and health professionals, may be a more realistic approach than replicating the hospice environment in order to reduce the burden of hospitalisations for patients with palliative care needs.

Cuba and the Covid-19 pandemic

2021 ◽  
Vol 122 (1) ◽  
pp. 118-131
Author(s):  
Bob Oram
Keyword(s):  
Public Health ◽  
United States ◽  
Health System ◽  
Health Professionals ◽  
The United States ◽  
The Past ◽  
The Uk ◽  
Universal Health

For the UK struggling to deal with the Covid-19 pandemic, the experience of Cuba’s Ministry of Public Health over the past six decades provides the clearest case for a single, universal health system constituting an underlying national grid dedicated to prevention and care; an abundance of health professionals, accessible everywhere; a world-renowned science and biotech capability; and an educated public schooled in public health. All this was achieved despite being under a vicious blockade by the United States for all of that time.

Impact and paybacks of biomedical research findings in Malaysia 2005–2015

2021 ◽  
Author(s):  
Pei Kuan Lai ◽  
S Nalliah ◽  
CL Teng ◽  
NLP Chen
Keyword(s):  
Decision Making ◽  
Health System ◽  
Capacity Building ◽  
Biomedical Research ◽  
Knowledge Production ◽  
Future Research ◽  
Relevant Research ◽  
Research Findings ◽  
The Impact ◽  
Health System Policy

Background: Impact in research encompasses health, economic, and cultural benefits beyond adding to the knowledge base. Funders are under immense pressure to be accountable for the paybacks from funded research.Aims and objectives: The aim of this study was to look into the impact of funded biomedical research between the years 2005 and 2015 in Malaysia from the aspects of knowledge production, research targeting and capacity building, as well as health system policy and decision making.Methods: This study employed a convergent parallel mixed-methods research design. Biomedical projects related to breast cancer, coronary heart disease, and dengue, funded by the Ministry of Health (MOH), Ministry of Higher Education (MOHE), and Ministry of Science, Technology, and Innovation (MOSTI) between the years 2005 and 2015, were included.Findings: From the questionnaire responses (n=58), on average each funded project managed to produce two outputs and one higher degree student. More than half (61.4%) of the funded projects led to subsequent future research. However, low citations in systematic reviews (10.3%), health policies (6.9%), and clinical practice guidelines (5.2%) were reported. In-depth interviews with the key opinion leaders also saw that most of the local research findings were found to be irrelevant to be adopted into policies by the policymakers.Discussion and conclusions: Paybacks on knowledge production as well as research targeting and capacity building had been achieved, but impact on health system policy and decision making had not been well attained, due to the lack of relevant research findings needed by the policymakers.<br />Key messages<br /><ul><li>Payback on knowledge production was achieved, as there had been a lot of new knowledge generated as captured in academic publications, conference proceedings, policy briefs, technical reports, and research highlights, which is important to advance the frontiers of knowledge.</li><br /><li>Payback on research targeting was achieved, with the current research leading to future study with identification of the knowledge gap and generation of new ideas for new research.</li><br /><li>Payback on capacity building was achieved with the training of researchers, building up research capacity and competencies, production of MSc and PhD graduates, promotion of lecturers, and development of new partnerships and networks.</li><br /><li>Impact on health system policy and decision making was not well attained. There had been a lack of relevant research data and findings being incorporated into policymaking, due to the basic and fundamental nature of most of the funded biomedical research in Malaysia.</li></ul>

scholarly journals Interventions geared towards strengthening the health system of Namibia through the integration of palliative care

2016 ◽  
Vol 10 ◽  
Author(s):  
Rachel Freeman ◽  
Emmanuel BK Luyirika ◽  
Eve Namisango ◽  
Fatia Kiyange
Keyword(s):  
Palliative Care ◽  
Health System
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