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Perinatal palliative care in sub-Saharan Africa: recommendations for practice, future research, and guideline

Mahlet Abayneh1, Sharla Rent2,3, Peter Odion Ubuane4

  • 1Department of Pediatrics and Child Health, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Frontiers in Pediatrics
|July 12, 2023
PubMed

Insights

Sub-Saharan Africa faces the highest neonatal mortality. This review compares palliative care (PC) in high-income countries and low-resource settings, proposing context-specific interventions for dying newborns and families.

Area of Science:

  • Neonatal mortality
  • Palliative care
  • Global health disparities

Background:

  • Sub-Saharan Africa bears 43% of global neonatal deaths.
  • Palliative care (PC) is underutilized in perinatal settings.
  • Resource limitations hinder PC implementation in low-and-middle-income countries (LMICs).

Purpose of the Study:

  • Compare perinatal/neonatal PC in high-income countries (HICs) and LMICs in sub-Saharan Africa.
  • Identify research-informed interventions for resource-deprived settings.
  • Propose actionable recommendations for clinical care and guideline development.

Main Methods:

  • Narrative review of perinatal/neonatal palliative care.
  • Comparison of PC strategies in HICs and LMICs.
  • Analysis of barriers to PC implementation in sub-Saharan Africa.

Main Results:

  • Significant disparities exist in PC availability and adherence between HICs and LMICs.
  • Lack of guidelines, resources, and trained professionals impede PC in sub-Saharan Africa.
  • Sociocultural contexts require tailored PC interventions.

Conclusions:

  • Context-specific, research-informed interventions are crucial for improving neonatal PC in sub-Saharan Africa.
  • Actionable recommendations can support clinical care and guideline development in resource-deprived environments.
  • Addressing disparities in neonatal palliative care is essential for reducing global mortality.

Keywords:
low-middle-income-countriesneonatal end-of-life careneonatal intensive carenewborn bereavementperinatal palliative caresub-saharan Africa

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