Palliative care in Africa since 2005: good progress, but much further to go

Abstract

There has been rapid progress in palliative care in Africa since the World Health Assembly in 2005 which identified palliative care as an urgent humanitarian need. Palliative care is now recognised as a basic human right, and momentum has gathered to translate this into action. From being significantly present in only five countries in 2004, palliative care is now delivered in nearly 50% of African countries. Even so, still less than 5% of people in need currently receive it, and with an estimated 300% increase in the need for palliative care for people with non-communicable diseases over the next 20 years, and with those living with HIV needing more prolonged support, the demand for palliative care will continue to outpace supply. African countries adopting a public health approach and networking together through palliative care associations are beginning to embed and integrate palliative care into health systems and communities. Current challenges are to increase coverage while maintaining quality, to develop dynamic and flexible responses to the changing illness patterns in Africa, and to counter false beliefs. Resourcefulness and harnessing new technologies such as mobile phones while respecting cultural traditions, may be the way forward. The authors review recent progress in policy, service provision and training initiatives in Africa, illustrate the current situation at grass roots level from a recent evaluation of programmes in Kenya, Malawi and Uganda, analyse the current urgent challenges and suggest some ways ahead.

Does involving volunteers in the provision of palliative care make a difference to patient and family wellbeing? A systematic review of quantitative and qualitative evidence

“…More people are dying from chronic diseases, and the demand for, and provision of palliative care is growing (Grant et al, 2011;Lynch et al, 2011;Morrison and Meler, 2011). This type of care may be needed over weeks or even months and there is growing recognition that provision should be for all, irrespective of age or diagnosis (Radbruch et al, 2013).…”

Developing a palliative care service for children in the Queen Elizabeth Central Hospital, Blantyre, Malawi

“…In 2002, the African Palliative Care Association was formed,10 and under its guidance, the Palliative Care Association of Malawi (PACAM) was established in 2005 11. PACAM provides courses in palliative care, though these are not specifically for children.…”

Symptom Prevalence and Burden in Cancer Patients with and without HIV/AIDS Reffered for Palliative Care

“…Early palliative care in cancer patients has been seen to greatly improve their quality of life, mood and it decreases the use of aggressive care at their end of life but still prolonging their survival [3]. In a recent review that assessed Africa's palliative care progress since 2005, Grant et al noted that a lot had been achieved in the past 10 years, including (1) integrating palliative care delivery into the national health systems of 28 out of 57 countries, (2) providing oral morphine, a cheap and strong analgesic in 48 countries, (3) an increase in post graduate and undergraduate palliative care courses in African Universities and (4) over 141 donors in Africa that are taking palliative care forward [4]. Despite these achievements, there is still a huge and unmet need for palliative care in low resource settings like Uganda.…”