Perceived policy-related barriers to palliative care implementation: a qualitative descriptive study

Area of Science:

• Healthcare Policy
• Public Health
• Palliative Care

Background:

• Ethiopia has a national palliative care guideline and policy recognition.
• Palliative care delivery is not fully realized in regional public hospitals and primary healthcare units.

Purpose of the Study:

• To explore perceived policy barriers to palliative care service delivery in rural and regional Ethiopian healthcare settings.
• Focus on barriers within primary healthcare units, which largely serve these populations.

Main Methods:

• Face-to-face interviews conducted in a rural Ethiopian region.
• Forty-two participants from primary, secondary, and tertiary healthcare levels, including policymakers, pharmacists, doctors, health officers, and nurses.
• Thematic analysis used to analyze interview data.

Main Results:

• Key policy barriers identified: lack of government priority, low awareness of national plans among professionals, and poor integration into the healthcare system and budget.
• Palliative care services were predominantly limited to HIV patients, often reliant on unsustainable external support.
• Limited government focus and support result in inadequate palliative care access for those in need.

Conclusions:

• Policy priority and government focus are crucial for effective palliative care provision.
• Integrating palliative care into all healthcare levels, especially primary care and the health extension program, is recommended.
• This integration would enable health extension workers to support millions in rural areas.