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
2011 ◽  
Vol 26 (4) ◽  
pp. 322-335 ◽  
Author(s):  
Jonathan Sussman ◽  
Lisa Barbera ◽  
Daryl Bainbridge ◽  
Doris Howell ◽  
Jinghao Yang ◽  
...  

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.


2010 ◽  
Vol 26 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Cheryl Arenella ◽  
Bruce Finke ◽  
Timothy Domer ◽  
Judith S. Kaur ◽  
Melanie P. Merriman ◽  
...  

2019 ◽  
Vol 57 (2) ◽  
pp. 474
Author(s):  
Timothy Poore ◽  
Catherine Deamant ◽  
Bridget Sumser ◽  
Anne Kinderman ◽  
Heather Harris

2018 ◽  
Vol 55 (2) ◽  
pp. 660
Author(s):  
Anne Kinderman ◽  
Heather Harris ◽  
Kathleen Kerr ◽  
Michael Rabow ◽  
Brian Cassel

Health Policy ◽  
2009 ◽  
Vol 93 (1) ◽  
pp. 11-20 ◽  
Author(s):  
Nils Schneider ◽  
Sara Lena Lückmann ◽  
Mareike Behmann ◽  
Susanne Bisson

2017 ◽  
Vol 74 (1) ◽  
pp. e6-e8 ◽  
Author(s):  
Jennifer Pruskowski ◽  
Robert Arnold ◽  
Susan J. Skledar

Stanovnistvo ◽  
2015 ◽  
Vol 53 (1) ◽  
pp. 19-38
Author(s):  
Marta Sjenicic

Vulnerable social groups can be recognized in everyday life, and local legal regulations identify them as well. Strategies and laws clearly identify the increased needs of vulnerable groups. Local legislation, for example, observes comparative law trends and attempts to prevent discrimination of persons with disabilities, emphasizes their human rights and creates the legal framework for taking these persons out of the institutional form of protection and including them into the community. In Serbia however, strategies and laws, as well as by-laws, are written in sectors, and not in cross-sectors manner. Proper caring for persons with disabilities, including persons with mental disabilities, requires an integral approach, namely a mutual approach of the social, health, educational and other sectors. True enough, local regulations stress the need for an intersectional approach, but such an approach is scantily applied in practice, so the comprehensive care that would satisfy the multiple needs of persons with mental disabilities often turns out to be less than expected in the community. Pursuant to national laws and basic ethic principals, all citizens of the Republic of Serbia have the right to health protection without discrimination. Therefore, methods for using health protection, easier than the existing ones, should be found for certain vulnerable groups, depending on their characteristics, and so for the Roma as well, and bearing in mind that systemic health regulations in Serbia open the door to special treatment of these groups. The inaccessible approach to health care of the Roma population persists primarily due to insufficient basic health documentation and basic personal documentation. Personal documents are linked with the registered place of residence, which the Roma, largely do not have. The problem is thus on a wider scale and is not only focused on the health sector. As such, it requires a wider, intersectional approach and a coordinated solution to the problem. In the field of palliative care of terminally ill persons, a solution is on the way to be reached through the Strategy for Palliative Care, by reorganizing the health system. The health system as it is cannot fulfill the needs of persons requiring palliative care. Coextensive systems enable establishing hospices as charity organizations in the non-governmental sector, mainly financed from donations. They represent a support to the health system in taking care of terminally ill patients. For now, our legal system does now allow non-governmental organizations to engage in health activities, although there were initiatives in that direction. To some extent, national regulations offer a basis for treatment of patients with rare illnesses, but without specifying their rights to a diagnosis or treatment and without more detailed regulations on the allocation of funds directed towards diagnosing rare illnesses and treatment of the ill. A lack of legal and financial prerequisites makes them subject to discrimination. The very fact that a large number of these patients are children makes them twice as endangered category of population. The legal system has recently started dealing with a regulation that would support persons suffering from rare illnesses, but the implementation of these provisions has still not completely become a reality. The Law on Health Care and Insurance defines children and women in their reproductive period as an especially vulnerable group. The Law on Rights to Healthcare for Children, Pregnant Women and Women on Maternity Leave, has recently been brought. The Law has been brought with an aim of ensuring rights to health care and transportation costs benefits for children, pregnant women and mothers during maternity leave, regardless of the basis on which they have health insurance. The reason for bringing such a law is noble, but the form of the legal act, which was supposed to realize the set goal, was overemphasized and contributed to the already existing over-norming of Serbian legislature. The legal basis for regulating this issue already existed in the umbrella health laws and should have been realized through by-law regulations.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 171s-171s
Author(s):  
A. Mubeneshayi Kananga

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.


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