A descriptive analysis of hospital-based palliative care services: a case study from Fort Portal Regional Referral...

Palliative care availability in public hospitals is critical for strengthening health services and expanding access to specialist support for individuals with complex needs from chronic, life‑limiting illnesses. This study examined attendance patterns, diagnostic distribution, and service pathways at a referral hospital in Uganda.

An institutional descriptive case study was conducted at Fort Portal Regional Referral Hospital, serving the Rwenzori subregion. Facility records and palliative care unit documentation were reviewed. Data sources included HMIS 008 registers, the EAFYA electronic medical records system, and District Health Information System (DHIS2) reports. Attendance was analysed using descriptive statistics, while integration into hospital services was evaluated through service pathways derived from thematic analysis of reported activities. Proportions of patients attending the unit relative to those potentially requiring end‑of‑life pathways and inpatient palliative care were assessed.

Between July 2019 and May 2026, 2,133 patients attended the palliative care unit. Of these, 1,248 (60%) had cancer, 55 (3%) HIV/AIDS, 174 (8%) sickle cell disease, and 656 (31%) other conditions. Children comprised 6% of attendees. Attendance increased in 2025-2026, driven primarily by outpatient visits (65%). Service pathways demonstrated intra‑hospital and inter‑hospital linkages that supported collaborative care planning, psychosocial support, continuity of care, and knowledge sharing.

Attendance at the FPRRH palliative care unit indicates expanding access, with service pathways suggesting integration into hospital services. Notable gaps include limited pediatric access, low inpatient coverage and under‑representation of non‑cancer chronic conditions, which account for a substantial share of patients likely to experience serious health‑related suffering. Larger multi‑site studies are warranted to evaluate access relative to need and to identify strategies for equitable scaling of palliative care across Uganda's public hospitals.