Challenges in Palliative Care Provision in Ethiopia: An Exploratory Qualitative Study.

Abstract

The prevalence of chronic illnesses is increasing at an alarming rate in Ethiopia. However, the existing palliative care service is not adequate to address the palliative care need of the patients and their families. This demands the need to explore, among other things, the challenges in palliative care provision. Thus, this article aimed to examine the challenges of palliative care provision in Ethiopia. The study considered Ethiopia as a case and examined the topic using a qualitative exploratory design. The data used in the study were collected through 29 in-depth interviews and 5 focus group discussions with health professionals and other stakeholders and analyzed using thematic analysis technique with ATLAS-ti 7.0 computer software. This study explored patient-related, provider-related, health system-related and partnership-related challenges/gaps in palliative care in Ethiopia. Patient-related factors include, delay in seeking medical care, lack of awareness of disease conditions, discontinuation of treatment due to inability to pay, a lack of follow-up care by considering cancer diagnosis as end of life/death and preferring dying at home. Provider-related challenges include lack of awareness of palliative care, lack of pre-service/in-service training for health professionals, absence of palliative care in the curricula of health programs and scarcity of research information on palliative care in Ethiopia. Health-system challenges include lack of drug, reagent shortage, limited chemotherapy and radiotherapy services, and weak facility-community linkage. Finally, lack of collaborators between governmental and non-governmental organizations was seen as a challenge to the provision of palliative care in Ethiopia. The study revealed that the challenges to palliative care provision in Ethiopia include patient-related factors, provider-related factors, health facility-related factors and partnership-related factors. Therefore, it is vital to take these challenges into account in order to improve the current palliative care service provision in Ethiopia.