Palliative Services: Provision, Accessibility, Future

Approximately 5–10 million people living with cancer, HIV/AIDS and other life-limiting illnesses need palliative care across Africa annually. Palliative care is the active and total (holistic) care of patients and their families by a multi – professional team especially when the patients’ disease is no longer responsive to curative treatment. Such care is however poorly developed in most of Africa. Although palliative care started in Africa in 1979 when Island Hospice was founded in Harare, Zimbabwe, very few countries in the 48 countries constituting Sub-Saharan Africa (SSA) currently have palliative care integrated into their health or cancer strategic plans, or have developed stand-alone national palliative care policies. Only five countries have palliative care integrated in the training curriculum of health professionals. Most of the countries still practice the hospital and home-based care model of service provision, which is built around trained health professionals, family care givers, and community-based volunteers rather than all the components of the WHO enhanced public health model. However, more educational activities through palliative care organizations, Universities, global organizations, and national palliative care associations continue to increase trained palliative care teams across SSA. Recent initiatives through cooperation between national governments, local and international non-governmental organizations are also providing innovative approaches to improve access to pain relief for patients and reduce barriers. Coordinated action will be required to ensure access to appropriate palliative care for those with life limiting illnesses, the elderly and the dying especially in this era of family migrations.