Abstract
ObjectivesThis qualitative study explores Nigerian health care professionals’ concepts of good dying/a good death and how telemedicine technologies and services would fit the current Nigerian palliative care practice.Materials and MethodsSupported by the Centre for Palliative Care Nigeria (CPCN) and the University College Hospital (UCH) in Ibadan, Nigeria, the authors organized three focus groups with Nigerian health care professionals interested in palliative care, unstructured interviews with key role players for palliative care and representatives of telecom companies, and field visits to primary, secondary and tertiary healthcare clinics that provided palliative care. Data analysis consisted of open coding, constant comparison, diagramming of categorizations and relations, and extensive member checks.ResultsThe focus group participants classified good dying into 2 domains: a feeling of completion of the individual life and dying within the community. Reported barriers to palliative care provision were socio-economic consequences of being seriously ill, taboos on dying and being ill, restricted access to adequate medical–technical care, equation of religion with medicine, and the faulty implementation of palliative care policy by government. The addition of telemedicine to Nigeria’s palliative care practice appears problematic, due to irregular bandwidth, poor network coverage, and unstable power supply obstructing interactivity and access to information. However, a tele-education ‘lite’ scenario seemed viable in Nigeria, wherein low-tech educational networks are central that build on non-synchronous online communication.DiscussionNigerian health care professionals’ concepts on good dying/a good death and barriers and opportunities for palliative care provision were, for the greater part, similar to prior findings from other studies in Africa. Information for and education of patient, family, and community are essential to further improve palliative care in Africa. Telemedicine can only help if low-tech solutions are applied that work around network coverage problems by focusing on non-synchronous online communication.
Highlights
IntroductionThe WHO estimates that in Africa each year approximately 961.000 adults and 537.000 children are in need of palliative care at the end of life [1]
A tele-education ‘lite’ scenario seemed viable in Nigeria, wherein low-tech educational networks are central that build on non-synchronous online communication
The WHO estimates that in Africa each year approximately 961.000 adults and 537.000 children are in need of palliative care at the end of life [1]
Summary
The WHO estimates that in Africa each year approximately 961.000 adults and 537.000 children are in need of palliative care at the end of life [1]. Realization of palliative care’s internationally recognized core values—to improve the quality of life of patients and their relatives facing a life threatening illness by early identification and impeccable assessment of pain and other problems—would strongly benefit these patients [2,3,4,5,6]. Palliative care’s values are internationally recognized, a socio-cultural context defines the final interpretation and realization of these values. The WHO, anticipating on this ‘couleur locale’, focuses on a ‘community health approach’ to improve palliative care in Africa [8]. Different projects stimulate ‘team development and networking with community-focused action’, training and education, and integration of care with a special emphasis on home-based care
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