The general lack of palliative care in national health policies, education programmes and health services leads to health systems that are too weak to achieve quality and comprehensive services for their populations. Yet palliative care interventions, based on WHO's public health model and health systems agenda have great potential for strengthening health systems to deliver quality services. APCA is implementing strategies that target all these components and pillars of the health system, as well as the stakeholders within these, including: policy makers, legislators, service providers and educationalists.
Several factors exert an adverse influence on the provision of palliative care services for the majority of people in Africa. Firstly, palliative care is a relatively new discipline on the continent and its development is hampered by the fact that it is not integrated into national health systems. Consider the following status samples of palliative care in 53 African countries:
Most palliative care is provided by non-governmental, faith-based or community-based organisations with no inbuilt sustainability mechanisms. These challenges are exacerbated by poor health and social care infrastructures in many African countries as well as the lack of available health financing. In addition, there is a widespread lack of understanding of what palliative care actually is and its corresponding benefits. Palliative care is often perceived to be synonymous with end of life care, death and hospice, or as a means of relief for physical pain exclusively.
APCA encourages governments throughout Africa to make use of the four-pillar enhanced public health model of palliative care provision to support a population- based approach to palliative care development. This approach focuses on palliative care integration into national health systems to increase service accessibility for patients in need.
Uganda has also integrated palliative care in its national health policy besides its integration in the national health strategic plan.