APCA Resources

Universal health coverage (UHC) has a central place in achieving the Sustainable Development Goals (SDGs) by 2030, as it is a major target (3.8) under SDG 3 (Ensuring healthy lives and promote well-being for all at all ages). The World Health Organization defines Universal Health Coverage (UHC) as a means through which all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship. UHC brings hope of better health and protection for the world’s poorest [1].

Report from accelerating palliative care development in West Africa Interest Group meeting held during the 5th African international conference in August 2016

While remarkable palliative care interventions have been undertaken in Eastern and Southern Africa, especially in the Anglophone countries, there is still a lot to be done for the West African and Francophone countries. Countries in West Africa have had very limited or no known palliative care interventions. Integration of palliative care in policy, education, health service delivery as well as availability of palliative care medicines and technology are very limited in this region. The few palliative care capacity building and awareness raising activities in West Africa have been isolated interventions. Below are maps extracted from the Global Atlas on palliative care showing the status/levels of palliative care in the world. It is observed that most West African countries either do not have known palliative care activities or have isolated provision of palliative care.

Highlights from the field on the  impact of the palliative care and access to controlled medicines advocacy workshops held during the 5th African international conference in August 2016

In August 2016, and as Fifth African International Palliative Care Conference which took place from the 16th to 19th August 2016 at Speke Resort and Conference Centre, Munyonyo in Kampala, Uganda the Open Society Foundations (OSF), Open Society Initiative for Eastern Africa (OSIEA) and Open Society Initiative for Southern Africa (OSISA) held three important workshops, in an effort to improve access to palliative care and controlled medicines for pain relief.

This is a practical manual on how to plan and implement palliative care services, integrated into existing health-care services, at national or subnational level. It has been designed primarily for health programme managers at national, provincial, or district level, whether they are responsible for noncommunicable diseases, infectious disease programmes, health services, or other technical areas where palliative care is important.

A high burden of complex symptoms and concerns among ambulatory patients diagnosed with cancer, diabetes, chronic respiratory and cardiovascular diseases.A case study of two countries in Southern Africa

Key findings: The three palliative-care-related problems with the highest intensity were: shared feelings (not at all/not very often); help and advice (none/very little); and worry (most/all the time). The most prevalent physical symptoms across the range of diseases being considered were pain and lack of energy. Cough and difficulty sleeping were common in patients with CRD, while dry mouth, numbness, difficulty sleeping and hunger affected diabetic patients. Weight loss was most common in cancer patients. Worry was the most common psychological symptom, reported across the range of patients, although feeling irritable was more common in cancer patients. Qualitative data also revealed the economic burden of NCDs from the patient’s perspective. Costs related to transport and medication were a common theme.

There is a growing recognition in Africa of the importance of addressing non-communicable diseases (NCDs) and advancing palliative care service provision for these patient groups. However, international funding in response to the AIDS epidemic has arguably focused palliative care delivery away from patients with non-HIV diagnoses, such as NCDs.

A starting point in addressing the lack of access to adequate palliative care for patients with an NCD diagnosis is an assessment of the physical, social, psychological and spiritual symptom burden experienced by patients with an active, life-limiting NCD diagnosis. Minimal work has been undertaken to investigate this area in sub-Saharan Africa. This study aimed to contribute to the burgeoning NCD global agenda by conducting an exploratory study of the palliative care-related problems of patients diagnosed with one of the four most prevalent NCDs in the region.

Africa is characterised by a significant burden of communicable and non-communicable diseases, especially in sub-Saharan Africa, the relative distribution of which is projected to shift by 2030.1  Despite positive advances over the last decade, including an increased number of service providers,2-4 provision of palliative care on the continent remains inconsistent, largely still provided from isolated centres with restricted geographic and population coverage rather than meaningfully integrated into healthcare structures. This work was supported by the Open Society Initiative for Southern Africa 

Several studies have been published reporting the status of palliative care in different countries in Africa, but none on the comparative status of the discipline in Southern Africa.  This report provides a summary of the current situation. The aim of this project was to collect up-to-date information on the degree of palliative care development in a number of targeted countries to address existing information deficits and establish development needs in each country to influence the progress of palliative care in the region. This work was supported by the Open Society Initiative for Southern Africa 

Opioids are indispensable medicines in the management of moderate to strong pain. According to the Worldwide Hospice Palliative Care Alliance (WHPCA), around three-quarters of adults who need palliative care are in low- and middle-income countries where many African countries sit. The highest rates of people living with HIV and AIDS who need palliative care are also said to be in Africa. The WHPCA further reports that half of the children with palliative care needs are in Africa. According to the International Narcotics Control Board (INCB), four-fifths of the world’s population (most of which resides in developing countries) do not have access to strong analgesia. The INCB also states that knowledge and attitudes towards controlled medicines, as well as restrictive national policies on such medicines, all affect opioid access and availability.

The knowledge, attitudes and practices of personnel in relation to opioid use in Swaziland, Mozambique and Zimbabwe, as well as the relevant national policies of those countries, had not previously been systematically assessed. This 2014 review

In April 2012, the UK Department for International Development approved a three-year project through the Tropical Health Education Trust's (THET) Health Partnerships multi-country partnership scheme to support the programme for strengthening palliative care integration into national health systems in four African countries (Kenya, Rwanda, Uganda and Zambia). The grant was awarded to the Global Health Academy at the University of Edinburgh (UoE), who work in conjunction with the African Palliative Care Association (APCA), and Makerere University Palliative Care Unit (MPCU). This report highlights lessons and best practices identified through the final project evaluation.