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ADVANCING PALLIATIVE CARE IN THE UGANDA HEALTH SYSTEM: AN EVIDENCE-BASED POLICY BRIEF

Published online by Cambridge University Press:  30 March 2015

Harriet Nabudere ,
Ekwaro Obuku  and
Mohammed Lamorde
Harriet Nabudere
Affiliation:
Regional East African Community Health (REACH) Policy Initiative, Uganda and Supporting the Use of Research Evidence (SURE) for Policy in African Health Systems Project, College of Health Sciences, Makerere University, hnabudere@gmail.com
Ekwaro Obuku
Affiliation:
Regional East African Community Health (REACH) Policy Initiative, Uganda and Supporting the Use of Research Evidence (SURE) for Policy in African Health Systems Project, College of Health Sciences, Makerere University, hnabudere@gmail.com
Mohammed Lamorde
Affiliation:
Infectious Diseases Institute, Makerere University
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Abstract

Objectives: This paper describes the development and findings for a policy brief on “Advancing the Integration of Palliative Care into the National Health System” and the subsequent use of this report.

Methods: Key stakeholders involved with palliative care helped identify the problem and potential policy solutions to scale up these services within the health system. A working group of national stakeholder representatives and external reviewers commented on and contributed to successive drafts of the report. Research describing the problem, policy options and implementation considerations was identified by reviewing government documents, routinely collected data, electronic literature searches, contact with key informants, and reviewing the reference lists of relevant documents that were retrieved.

Results: The palliative burden is not only high but increasing due to the rise in population and life expectancy. A few options for holistic, supportive care include: Home-based care increases chances of a peaceful death for the terminally ill surrounded by their loved ones; supporting informal caregivers improves their quality of life and discharge planning reduces unscheduled admissions and has the potential to free up capacity for acute care services. A combination of strategies is needed to effectively implement the proposed options as discussed further in this article.

Conclusions: The policy brief report was used as a background document for two stakeholder dialogues whose main outcome was that a comprehensive national palliative care policy should be instituted to include all the options, which need to be integrated within the public health system. A draft policy is now in process.

Keywords

PalliativeTerminalEnd-of-lifeUganda
Type
Policies
Information
International Journal of Technology Assessment in Health Care , Volume 30 , Issue 6 , December 2014 , pp. 621 - 625
Copyright
Copyright © Cambridge University Press 2015 

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References

REFERENCES

1. SURE. SURE guides for preparing and using evidence-based policy briefs. Version 2.1: The SURE Collaboration; 2011. http://global.evipnet.org/sure/ (accessed February 21, 2012.Google Scholar
2. Stjernswärd, J. Palliative care: The public health strategy. J Public Health Policy. 2007;28:42–55.Google Scholar
3. Kikule, E. A good death in Uganda: Survey of needs for palliative care for terminally ill people in urban areas. BMJ. 2003;327:192–194.Google Scholar
4. Nabudere, H, Lamorde, M. “Palliative Care in Uganda” terms of reference for the evidence brief. Kampala: Makerere University, College of Health Sciences; 2011.Google Scholar
5. Amandua, J. The prevalence of life-limiting illnesses among patients at Mulago National Referral Hospital. London: King's College London; 2011.Google Scholar
6. UBOS. 2002 Uganda population and housing census. Kampala, Uganda: Uganda Bureau of Statistics; 2002.Google Scholar
7. HAU. Annual report 2011. Kampala: Hospice Africa Uganda; 2011.Google Scholar
8. Gray, G, Berger, P. Pain in women with HIV/AIDS. Pain. 2007;132 (Suppl 1):S13–S21).CrossRefGoogle ScholarPubMed
9. Hudson, PL, Aranda, S, Hayman-White, K. A psycho-educational intervention for family caregivers of patients receiving palliative care: A randomized controlled trial. J Pain Symptom Manage. 2005;30:329–340.CrossRefGoogle ScholarPubMed
10. Candy, B, Jones, L, Drake, R, Leurent, B, King, M. Interventions for supporting informal caregivers of patients in the terminal phase of a disease. Cochrane Database Syst Rev. 2011;6:CD007617.Google Scholar
11. Powell, RA, Mwangi-Powell, , Kiyange, F, Radbruch, L, Harding, R. Palliative care development in Africa: How can we provide enough quality care? BMJ Support Palliat Care. 2011;1:113–114.CrossRefGoogle ScholarPubMed
12. APCA. Strategic plan: 2011–2020. Kampala, Uganda: African Palliative Care Association; 2011.Google Scholar
13. Shepperd, S, Wee, B, Straus, SE. Hospital at home: Home-based end of life care. Cochrane Database Syst Rev. 2011;7:CD009231.Google Scholar
14. Harding, R, List, S, Epiphaniou, E, Jones, H. How can informal caregivers in cancer and palliative care be supported? An updated systematic literature review of interventions and their effectiveness. Palliat Med. 2011;26:7–22.CrossRefGoogle ScholarPubMed
15. Shepperd, S, McClaran, J, Phillips, C, et al. Discharge planning from hospital to home (Review). Cochrane Database Syst Rev. 2010;1:CD000313.Google Scholar
16. Selker, H, Beshansky, J, Pauker, S, Kassirer, J. The epidemiology of delays in a teaching hospital. Med Care. 1989;27:112.Google Scholar
17. What are the impacts of discharge planning from hospital to home? A SUPPORT Summary of a systematic review [Internet]. 2011.Google Scholar
18. MOH. Village health team: A handbook to improve health in communities. Kampala: Ministry of Health; 2012.Google Scholar
19. Legg, LA, Quinn, TJ, Mahmood, F, et al. Non-pharmacological interventions for caregivers of stroke survivors. Cochrane Database Syst Rev. 2011;10:CD0081179.Google Scholar
20. Wisyonge, C. Which clinical guideline dissemination strategies improve professional practice? A SUPPORT Summary of a systematic review. 2008 August 2008. Report No.Google Scholar
21. Mbonye, AK, Asimwe, JB. Factors associated with skilled attendance at delivery in Uganda: Results from a national health facility survey. Int J Adolesc Med Health. 2010;22:249–255.CrossRefGoogle ScholarPubMed
22. UBOS. Uganda Demographic and Health Survey 2006. Kampala: UBOS; 2006.Google Scholar
23. Ministry of Health. Health sector strategic and investment plan. Kampala: Ministry of Health; 2010.Google Scholar
24. WHO. Cancer control, knowledge into action, WHO guide for effective programmes, palliative care. Switzerland: World Health Organization; 2007.Google Scholar
Supplementary material: File

Nabudere supplementary material

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Table S2

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