Abstract
BackgroundIn response to increased global public health funding initiatives to HIV/AIDS care in Africa, this study aimed to describe practice models, strategies and challenges to delivering end-of-life care in sub-Saharan Africa.MethodsA survey end-of-life care programs was conducted, addressing the domains of service aims and configuration, barriers to pain control, governmental endorsement and strategies, funding, monitoring and evaluation, and research. Both closed and qualitative responses were sought.ResultsDespite great structural challenges, data from 48 programs in 14 countries with a mean annual funding of US $374,884 demonstrated integrated care delivery across diverse settings. Care was commonly integrated with all advanced disease care (67%) and disease stages (65% offering care from diagnosis). The majority (98%) provided home-based care for a mean of 301 patients. Ninety-four percent reported challenges in pain control (including availability, lack of trained providers, stigma and legal restrictions), and 77% addressed the effects of poverty on disease progression and management. Although 85% of programs reported Government endorsement, end-of-life and palliative care National strategies were largely absent.ConclusionsThe interdependent tasks of expanding pain control, balancing quality and coverage of care, providing technical assistance in monitoring and evaluation, collaborating between donor agencies and governments, and educating policy makers and program directors of end-of-life care are all necessary if resources are to reach their goals.
Highlights
In response to increased global public health funding initiatives to HIV/AIDS care in Africa, this study aimed to describe practice models, strategies and challenges to delivering end-oflife care in sub-Saharan Africa
In 2002 the WHO estimates there were 29.4 million adults and children living with HIV/AIDS in Sub-Saharan Africa, with 2.4 million AIDS-related deaths and 3.5 million new infections
Even considering the current global focus on HIV treatment, it must be recognized that the nature of the disease, weak public health infrastructure and other factors [1] make quality palliative and end-of
Summary
In response to increased global public health funding initiatives to HIV/AIDS care in Africa, this study aimed to describe practice models, strategies and challenges to delivering end-oflife care in sub-Saharan Africa. This study is the first to gather and synthesize data from Sub-Saharan palliative and end-of-life care programs It aims to describe and analyse practice, policy and advocacy to inform future developments and research for building HIV palliative and end-of-life care in SubSaharan Africa. This is achieved through a cross-sectional survey describing current practice, priorities and challenges in end-of-life HIV/AIDS care
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