What is Palliative Care Awareness?
The Definition
Palliative care awareness is the comprehensive understanding that palliative and comprehensive chronic care is a holistic approach focusing on the person and their family from the time of diagnosis of a life limiting illness whether acute or chronic until complete recovery or death.
WHO Definition (2002)
"Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual."
The African Context
In the African context, using WHO's 2002 definition and principles, palliative and comprehensive chronic care is provided from the moment of diagnosis of a life limiting illness until complete recovery or death. This might be for a duration of months or years, not just days or weeks at the end of life.
The Awareness Gap
There remains poor awareness of palliative care as a discipline, a service, and a component of the continuum of care from health promotion to disease prevention, early detection, diagnosis and treatment, rehabilitation and palliation.
The Problem
Palliative care remains invisible across Africa because information never reaches those who need it. Despite years of advocacy, poor awareness persists across all stakeholder groups, creating barriers to access at every level of the health system.
🏛️ Policy Level
Governments Don't Know It's Required
Only 8 African countries have standalone palliative care policies. Ministries of Health lack awareness that palliative care is mandated by WHA Resolution 67.19 and essential for Universal Health Coverage.
- Limited understanding of palliative care as a human right
- Unfamiliarity with WHA Resolution 67.19 implementation
- Lack of policy frameworks and legal templates
👩⚕️ Clinical Level
Health Workers Lack Competencies
Most pre service medical and nursing curricula exclude palliative care. Clinicians don't know how to assess serious health related suffering, communicate prognoses, or access controlled medicines.
- Palliative care absent from pre service training
- No recognition as a medical specialty in most countries
- Insufficient knowledge of pain assessment
👥 Public Level
Communities Misunderstand the Service
Palliative care is widely viewed as "giving up" or "only for dying patients." Families don't know services exist, preventing early referral and access from diagnosis.
- Belief that palliative care is only end of life care
- Social taboos around death and opioid use
- No awareness of available services
⚙️ System Level
Integration Knowledge is Missing
Health system leaders don't know how to integrate palliative care into primary health care, HIV programs, cancer services, or national health information systems.
- Unclear how to integrate into PHC and UHC
- Lack of service delivery models
- Missing palliative care indicators in HMIS
Closing the Knowledge Gap
Closing the knowledge gap that prevents access to compassionate care across Africa. Awareness is the foundation upon which all other palliative care interventions are built. When policymakers know palliative care is a right, they fund it. When health workers know how to deliver it, patients suffer less. When communities know it exists, they demand access.
Why Awareness is Strategic Objective One
The APCA Strategic Plan 2020 2030 is structured around four strategic objectives. Awareness is positioned as Objective One because it is the prerequisite for all other interventions. Without knowledge, health systems cannot be strengthened, evidence cannot be generated, and sustainability cannot be achieved.
Increasing knowledge and awareness of palliative and comprehensive chronic care linked to advocacy through and with all stakeholders
Despite years of advocacy, there still remains poor awareness of palliative care as a discipline, a service, and a component of the continuum of care. This calls for targeted awareness creation among all key stakeholders from the patient and family, to health workers, managers, pharmacists, decision makers, policy makers and all those involved in healthcare provision, education, management, regulation and financing.
🎯 The Foundation Principle
Objective One is the foundation upon which Objectives Two, Three, and Four are built. Without awareness, there is no demand for services, no political will for policy change, and no recognition of palliative care as a human right.
🔄 The Synergy Effect
Awareness creates the enabling environment for health systems strengthening (Objective Two). When policymakers understand palliative care, they allocate budgets and develop policies. When health workers know how to deliver it, patients receive quality care.
📊 Evidence to Action Pipeline
Objective Three (Evidence) feeds into Objective One through knowledge translation. Research findings are transformed into accessible information that drives advocacy and policy change, ensuring evidence doesn't remain in academic journals.
💡 Sustainability Driver
Objective Four (Sustainability) depends on awareness to create a movement of informed advocates. When communities understand their rights to palliative care, they become active stakeholders demanding sustainable services, not passive recipients.
⚠️ Why This Matters Now
The information and knowledge gap around palliative and comprehensive chronic care is compounded by social taboos, such as fears of opioid abuse and the misconception that palliative care is only end of life care. As a discipline, palliative care is often viewed as an end of life intervention, especially in Western countries where insurance schemes place limits on when it should be provided. In the African context, this narrow understanding creates barriers to early access from diagnosis.
🔗 The Integration Imperative
The interaction of the four strategic objectives enhances coordinated activities that enable APCA to respond to demands for palliative care integration. However, this integration can only occur when stakeholders at every level from community health workers to Ministers of Health understand what palliative care is and why it matters for Universal Health Coverage.
The Context
APCA's awareness work operates within a complex landscape where inadequate knowledge levels block access across all systems. The Strategic Plan 2020 2030 positions awareness as the catalyst that activates the entire strategic framework.
🌍 The Enabling Environment
When policymakers know palliative care is a right, they fund it. When health workers know how to deliver it, patients suffer less. When communities know it exists, they demand access.
IEC (Information, Education, Communication) is not merely a communications function it is the primary driver of systems change and the mechanism through which Objective One catalyzes Objectives Two, Three, and Four.
📊 The Knowledge Continuum
Palliative care is often viewed as an end of life care intervention, especially in Western countries where insurance schemes place limits on when it should be provided. This narrow understanding creates barriers to early access in African contexts where the need starts at diagnosis.
The Reality: More than 80% of people who die with serious health related suffering are from developing countries, with the vast majority lacking access due to information gaps that prevent them from demanding care.
Knowledge is the first step to dignity. When patients and families understand their rights to pain relief and symptom control, they can advocate for the care they deserve.