The Integration of Palliative Care in DR Congo “A Model Of Sustainability”: A Field Study

Abstract

Background and context: In DR Congo, many cancer patients in the terminal phase of their condition have minimal access to palliative care. There is a combined effect of poverty, the deterioration of the health system and the absence of a well-defined national policy on palliative care. Patients are for the most part abandoned to the care of inexperienced family members. Driven by the fact that the number of palliative patients has been increasing steadily over the past five years, the Palliafamilli association and its partners have taken leadership in the fight for palliative care. The major issue that blocks palliative care in RD Congo is the lack of knowledge about palliative care both in the population and even in health professionals. Most patients are treated at home with strong family involvement in many aspects of care. Aim: To promote good health practices at the community level and equip them with the knowledge and means to prevent their health problems, with a focus on palliative care and to contribute to the implementation of the Strategy for Strengthening the Health System of DR Congo by facilitating a program of access to palliative care for the entire Congolese population. Strategy/Tactics: During the last 7 years, we have organized conferences, congresses, various training sessions on pain management, sensitization activities, capacity building courses and advocacy activities within the Ministry of Health for national palliative care guidelines. Program/Policy process: - The organization of two International Congress of Palliative Care in Kinshasa in April 2013 (550 participants) and September 2015 (700 participants) - Training of 3 health professionals on the palliative approach in Uganda (2013) - Participation at the Second Francophone Palliative Care Congress in Montreal 2013 - A palliative care training course at the University of Kinshasa in 2015 (115 participants) - The organization of the International Colloquium of Pediatric Palliative Care in Kinshasa in 2015 - Participation in the 4th International Francophone Congress of Palliative Care in Geneva (2017) - Participating in the drafting of national guidelines for palliative care within the Ministry of Health (2017) - Capacity building for two members of PalliaFamilli thanks to the scholarship offered by the UICC. What was learned: In DR Congo, palliative care and pain relief require a cross-cutting approach, as resources are limited, many people are in need of care, and there are few nurses and doctors empowered to provide care. An effective approach is to involve community or volunteer caregivers supervised by health professionals, and Palliafamilli is successful due in its multidisciplinary and multisectoral approach, with adaptation to cultural, social and economic specificities and its integration with existing health systems, focusing on primary health care and community and home care.