The evolution of hospice and palliative care in Ethiopia: From historic milestones to future directions

Abstract Introduction: This article reviews the genesis of hospice and palliative care in Ethiopia, examines recent progress, and makes recommendations for the way forward. Result:Although the delivery of palliative care in Ethiopia has shown significant progress over the past two decades, it remains patchy, with the interdisciplinary components of psychological, social and spiritual support lagging behind the primarily medical approach. Discusion: As a pillar of healthcare provision, and in conjunction with health promotion, disease prevention, curative services and rehabilitation, PC awareness and its development should be a high priority Conclusion: More research on the root causes of lack of integrated services for PC and genuine conversation is required [Ethiop. J. Health Dev. 2020; 34(4):310-312] Key words: Palliative care, Ethiopia, life-threatening chronic illness, hospice, end-of-life car

Patterns of Care of Cancers and Radiotherapy in Ethiopia

PURPOSE: Radiotherapy (RT) is an essential component of cancer treatment. There is a lack of RT services in sub-Saharan Africa as well as limited knowledge regar

Radiotherapy Practice for Treatment of Bone Metastasis in Ethiopia

PUROSE Ethiopia has one cobalt radiotherapy (RT) machine to serve a population of more than 100 million. The purpose of this study was to report on patterns of palliative RT of bone metastasis in a severely low-capacity setting. PATIENTS AND METHODS Patient and treatment characteristics of patients irradiated for palliation of symptomatic bone metastasis were extracted from a retrospective database of patients treated between May 2015 and January 2018. This database included a random sample of 1,823 of the estimated 4,000 patients who were treated with RT within in the study period. Associations between the applied RT schedule and patient and tumor characteristics were evaluated with the χ2 test. Hypothetical savings of RT sessions and time were compared in the case of a single-fraction policy. RESULTS From the database, 234 patients (13%) were treated for bone metastasis. Most patients were ≤ 65 years of age (n = 189; 80%) and female (n = 125; 53%). The most common primary sites were breast (n = 82; 35%) and prostate (n = 36; 15%). Fractionated regimens were preferred over single fraction: 20 Gy in 5 fractions (n = 192; 82.1%), 30 Gy in 10 fractions (n = 7; 3%), and 8 Gy in 1 fraction (n = 28; 12%). Factors associated with single-fraction RT included nonaxial sites of bone metastasis (P, .01) and an address outside Addis Ababa (P ≤ .01). If single-fraction RT would have been given uniformly for bone metastasis, this would have resulted in a 78% reduction in the number of RT sessions and 76% reduction in total RT time. CONCLUSION The pattern of palliative RT for bone metastasis in Ethiopia favors fractionated regimens over single fraction. Efforts should be made to adopt evidence-based and cost-effective guidelines