Michael Wright, David Clark, Jenny Hunt and Tom Lynch
This project was commissioned by the Diana, Princess of Wales Memorial Fund and the Elton John AIDS Foundation. Begun in the autumn of 2003, the project concluded in September 2006 with the publication of a major work on the development of hospice and palliative care in Africa.
In the foreword to the book, Sir Elton John says, “This book is a landmark document for anyone concerned about HIV/AIDS in Africa and the role of palliative care in supporting those affected by the epidemic that is occurring there. It lays down a solid platform of evidence about how hospice and palliative care services are developing across the continent and it provides a baseline against which to measure progress in the future. I commend this book to anyone interested in the fight against AIDS and in the struggle to promote palliative care across Africa.” |
 |
The project maps the state of palliative care in all 47 countries across the continent with the aim of providing information for governments, healthcare providers and funding agencies.
Aim:
To assess the current state of hospice and palliative care provision in Africa, mapping the existence of services country by country and exploring the perspectives and experiences of those involved, with a view to stimulating new development.
Methods and analysis:
Multi-method review involving a synthesis of evidence from published and grey documentary literature; ethnographic field visits to 7 countries; qualitative interviews with 94 individuals from 14 countries; collation of existing public health data. 47 African countries in total were studied. Participants were hospice and palliative care activists in Africa, including clinicians, managers, volunteers, policy makers and staff of donor organisations.
Results:
The 47 countries of Africa could be grouped into four categories: no identified hospice or palliative care activity (21); capacity building activity is underway to promote hospice and palliative care delivery (11); localised provision of hospice and palliative care is in place, often supported by external donors (11); hospice and palliative care services are achieving some measure of integration with mainstream service providers and gaining wider policy recognition (4). Major difficulties relate to: opioid availability; workforce development; achieving sustainable critical mass; absorption capacity in relation to major external funding initiatives; coping with the scale of the HIV/AIDS related suffering.
Conclusions:
Models exist in Uganda, Kenya, South Africa and Zimbabwe for the development of affordable, sustainable community-based hospice and palliative care services. The newly formed African Palliative Care Association has huge potential to promote innovation. Overall, interest in the development of hospice and palliative care in Africa has never been greater.
As Roger Woodruff states in the January 2007 edition of the International Association for Hospice and Palliative Care's "IAHPC News On-Line":
"This is the definitive text for anybody wanting to know anything about hospice and palliative care in Africa. One can only pray that it will need to be updated frequently as the situation improves."
Anne Merriman, Hospice Uganda, Kampala, reviews the book in Palliative Medicine, Vol 21, Issue 5 and says:
"This is an indispensable book for every palliative care library or resource centre with an interest in developing services in the world, for the donors who are assisting or about to assist in this great work, for public health specialists throughout the world and the Ministries of Health in Africa. It is also a must for all students of palliative medicine, particularly at degree and diploma levels. Dame Cicely's work is alive and well in these pages!"
