Improving access to palliative care for patients with cancer in Africa: 25 years of Hospice Africa.

All cancer care must target the needs of the whole population, not just the few who reach curative services. This paper will refer to palliative care in Uganda and in the countries now aware of the need for palliative care. Human Rights Watch has declared that doctors who are aware that we can control cancer pain and are not doing it or taking steps to make it happen, are considered to be torturers (Human Rights Watch (2009) Please, do not make us suffer any more... Accessed 11 July 2019). As Uganda celebrates 25 years since the introduction of palliative care, is it now time to harvest the principles that have been applied in policies and services from the Government of Uganda? This has brought Uganda to the same level as the developed world as stage 4b palliative care (PC) services [1]. These policies and services need to be promoted to caring governments in Africa, and suitably adapted to the needs of each African country, with a plan for them to progress over the next 5 years. These steps will ensure standards, economic viability and cultural appropriateness. Let palliative care reach at least 50% of cancer patients in need in Africa by 2023

Assessment of the Readiness and Availability of Palliative Care Services in Hospitals in Kampala, Uganda

Background: In Uganda, there are approximately 350,000 patients with illnesses needing palliative care (Merriman, Mwebesa & Katabira, 2012) and among whom 210,000 persons in painare in urgent need of Palliative care (American Cancer Society, 2014).Further, palliative care was introduced to improve the quality of life of patients and their families who are facing problems associated with life-threatening illness, whether physical, psychosocial or spiritual (Temel, 2010). More still, palliative care reduces unnecessary hospital admissions and the use of health services. However, the use of morphine and other controlled medicines that are essential for palliative careare overly restricted by regulations thereby hindering access to adequate pain relief and palliative care. Furthermore,palliative care has been incorporated into the Uganda’s Health Sector Strategic and Investment Plans but has been hampered by minimal resources and huge shortages of health workers. Further, Uganda has one of the most rapid growth of palliative care in Africa as well as the only country in sub-Saharan Africa graded as having “Stage 4” comprehensive palliative care according to the Global Atlas of Palliative Care (Worldwide Palliative Care Alliance, 2014). Additionally, Uganda was ranked 35th out of 80 countries for the Quality of death Index (Economist Intelligence Unit, 2015). Despite these accolades, hospital based palliative care is not universally available throughout the country. In 2014 the Ministry of Health provided only 103 million Uganda shillings for development of Palliative care in its national budget. This is a small amount to share, and as most hospitals received very little funding for palliative care, it is likely that hospital medical superintendents used discretionary funds to provide the service (O’Brien et al., 2013). Therefore, the objective of this study was to assess the readiness and availability of palliative Care services in hospitals in Kampala, Uganda from April, 2016 to June, 2016. Methods: A cross sectional study design was used. Results: The study found that 7 of the 27 hospitals (26%) were offering palliative care, 6 (22%) had a specialized staff offering palliative care and only 5 (19%) had a staff designated to coordinate palliative care services. Overall, the level of  readiness to provide palliative care was found to be very low with only 3 of the 27 hospitals (11%) demonstrating readiness as per the set criteria (availability of pain medication in stock, availability of morphine in stock and availability of a healthcare worker to provide palliative care). Conclusion: Readiness and availability of palliative care services is very low among hospitals in Kampala. Keywords: Palliative Care, Morphine, Readiness, Availabilit

Cancer and palliative care in COVID-19 and other challenging situations—highlights from the Uganda Cancer Institute—Palliative Care Association of Uganda 3rd Uganda Conference on Cancer and Palliative Care, 23–24 September 2021, held in Kampala, Uganda and virtually.

The 3rd Uganda Conference on Cancer and Palliative Care was held in September 2021 with the theme: cancer and palliative care in COVID-19 and other challenging situations. It was hosted by the Uganda Cancer Institute and the Palliative Care Association of Uganda (UCI-PCAU). The conference was held virtually, with a mix of pre-recorded sessions, plenary sessions being broadcast live on television (TV) by the Uganda Broadcasting Corporation TV, live speakers at the studio and others presenting in real time via Zoom. The conference brought together >350 participants who participated on Zoom, along with those attending in person at the studio and those watching the plenary sessions on TV. At the heart of this joint UCI-PCAU conference was the commitment to not only continue but to improve the provision of cancer care and palliative care within Uganda. Key themes from the conference included: the importance of Universal Health Coverage; the impact of COVID-19 on the provision of cancer and palliative care; that both cancer care and palliative care are available in Uganda; education for all; the importance of working together to provide care and overcome challenges, e.g. through technology; the resilience shown by those working in cancer and palliative care; the grief experienced by so many people who have lost loved ones during the pandemic; the importance of good health seeking behaviour - prevention is better than cure; the challenge of funding; the need for health care equity for marginalised and vulnerable populations and finally we can't wait for the world to stop COVID-19 - COVID-19 is here to stay - we need to find solutions. The last few years have seen significant challenges due to the COVID-19 pandemic; however, despite this, cancer and palliative care service provision has continued. This conference, whilst unique and very different from previous conferences, was a great opportunity to share not only amongst each other, but also to share key messages with the public through the live broadcasting of the plenary sessions of the conference