palliative in south africa . An overview ....

1. Palliative care in Africa
Presented by
Asmaa E.M.kanaan

2. Outlines
Why did I chose to talk about this study ?
Introduction
Statistics of Africa
History of palliative care in Africa
An overview of HAPCAs
Current priorities & Challenges
Recommendations
Conclusion
References

3. Why … This study ?
In response to increased global public
health funding initiatives to hospice and
palliative care in Africa, this study aimed
to describe practice models, strategies
and challenges to delivering end-of-life
care in Africa.

4. Introduction
The fundamental question of whether
palliative care is appropriate or possible
in developing countries ???
This Q has been posed .

5. Statistics of Africa
Africa population around 826 millions .
Africa the 2th largest of continents , it contains
22% of the earths land surface .
In Africa 20% of deaths are ill-defined ,and less
than 70% are registered .

6. Top 5 causes of death in Africa
*Ill-defined natural 13.8% .
*respiratory TB 11.1% .
*LRI 9.7% .
*intestinal infections disease 6.8% .
*HIV/AIDS 6.4% .
Cancer = 0.8% (19)

8. Place of death
Overall 43.9% of death occurred in hospitals
(include 1.8% outpatient ).
15% missing information about place of
death .
4.4% dead in home ( include 2.1% in nursing
home ).

9. History of palliative in Africa
In 1970s when first appeared in Zembabwe &
South Africa .
In June 2004 APCAs held its first annual
general meeting in Tanzania , Ghana
,Zimbabwe ,Nigeria ,South Africa ,Kenya ,
Uganda .
Egypt 2007 .

10. An overview on HAPCAs
A resarch has identified 136 hospice and
palliative care organizations in 15 countries (
an area with a population of 407 million
people ).
The majority are non-govermental .
Over half 76 were found in SA .

11. Government problem
- governments not knowing what palliative care is .
- lack of strategy detail .
- non-implementation at the local level .
strategies being informal .
- and lack of funding for implementation of
strategies .

12. 2007 resarchs finding
47 countries of Africa... Grouped into 4
categores :
1… No identified hospice or palliative care
activity ( 21 countries ) .
2… Capacty building activity is underway to
promote hospice and palliative care delivery
( 11 countries ) .

13. 3… localized provision of hospice and
palliative care is in place , often heavily
supported by external donors
( 11 countries ) .
4… Hospice and palliative care services are
recognition gaining wider policy
( 4 countries ) .
… SA, Zimbabwe ,Kenya, Uganda …

14. Current priorities
Current priorities grouped into 5
categories: epidemiological need and
service expansion, access and quality
assurance, advocacy, resources and
consolidation, and limitations .

15. Challenges
Governmental and cultural contexts , poverty
,lack of trained professionals, retention of
trained professionals, funding restrictions,
excessive stress on lay provision, prohibitive
drug costs, increasing patient load, weakness
in current health system infrastructure, and
lack of communication of effective strategies.

16. Pain relief … challenges
drug availability
lack of providers
transportation
government restrictions
funder restriction

17. Recommendation
We call on government to ensure that
palliative care is accessible, available and
affordable to Africans facing advanced
illness, and to ensure that at the end of
their lives patients are treated with
dignity and experience relief of suffering.

18. Conclusion
It’s a hard job but its
not impossible

19. References
south African Medical Journal 2001, 91:364-368.
Hospice and palliative care in africa , David clark
.PHD,Jennifer Hunt ,PHD .2007.
the African Palliative Care Association website
(http://www.africanpalliativecare.org),

20. Thank you