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Progress Update: Palliative Care Development Between 2017 and 2020 in Five African Countries.

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Summary

Palliative care development in Kenya, Rwanda, Uganda, South Africa, and Tanzania saw progress, with Kenya and Rwanda integrating services. Advocacy and technical aid improved patient access, though universal health coverage remains uncertain.

Keywords:
AfricaKenyaPalliative careRwandaSouth AfricaTanzaniaUgandacontrolled medicineshealth systemshospicemorphineuniversal health coverage

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Area of Science:

  • Public Health
  • Health Policy
  • Palliative Care Development

Background:

  • Pioneers in Kenya, Rwanda, South Africa, Tanzania, and Uganda established palliative care services starting in the mid-2000s.
  • Open Society Foundations (OSF) support has been instrumental in training healthcare providers and engaging policymakers.
  • The late 2010s saw a shift towards strategic communications and advocacy for integrating palliative care into universal health coverage.

Purpose of the Study:

  • To update on palliative care development in five African nations (Kenya, Rwanda, South Africa, Tanzania, Uganda) from 2017-2021.
  • To assess the impact of two decades of OSF support on integrating palliative care into public health systems.
  • To evaluate progress in patient access to palliative care services and essential medicines.

Main Methods:

  • A progress update and impact assessment approach was employed.
  • The study involved examining the integration of palliative care into publicly funded health systems.
  • A mixed strategy of advocacy, communications, and technical assistance was utilized.

Main Results:

  • By 2021, Kenya and Rwanda significantly scaled up palliative care within public health systems.
  • Uganda's government mandated public hospitals to offer palliative care services.
  • South Africa and Tanzania have not yet committed to publicly funded palliative care.

Conclusions:

  • Combining advocacy, communications, and technical assistance drives patient access to palliative care.
  • Full integration into universal health coverage remains a challenge, with Rwanda showing the most progress.
  • Sustained efforts are needed to ensure equitable access to palliative care across the region.