Availability of palliative care services in Zambia: A nationwide provincial and tertiary hospital survey. (June 2019)

• Record Type: Journal Article
• Authors: Frett Utter, Brigitte; Parham, Groesbeck P.; Mershon, Claire-Helene; Sikombe, Kombatende; Musonda, Agnes; Matambo, Jane; Kapambwe, Sharon; Msadabwe, S. Citonje; Katundu, Katundu; Bateman, Allen; Lishimpi, Kennedy; Mwanahamuntu, Mulindi; Chibwesha, Carla J.
• Is Part Of: Journal of cancer policy. Volume 20(2019)
• Publication Date: 2019-06
• Subjects: CDH cancer diseases hospital -- HFA health facility assessment -- PCAZ Palliative Care Association of Zambia -- WHO World Health Organization; Palliative care -- Sub-Saharan Africa -- Zambia; Cancer -- Government policy -- Periodicals; Cancer -- Patients -- Services for -- Periodicals; Medical Oncology -- Periodicals; Public Health -- Periodicals; Cancer; Periodicals; 362.196994
• DOI: 10.1016/j.jcpo.2019.100185
• Languages: English
• ISSNs: 2213-5383

Abstract

Highlights: Our work confirms the dearth of palliative care services across Zambia. Community- and home-based palliative care services are not commonly available. Access to essential palliative care medications also remains limited. Abstract: Background: With high rates of HIV/AIDS and rising burdens of non-communicable diseases, Zambians increasingly need palliative care. While efforts are underway to grow Zambia's palliative care system, the most recent situational analysis of palliative care in Zambia, conducted in 2008, revealed substantial gaps in availability. Methods: To provide an updated appraisal of breast and cervical cancer services in Zambia, including palliative care, we conducted a nationwide provincial and tertiary hospital survey. All 9 provincial hospitals and the University Teaching Hospital and Cancer Diseases Hospital in Lusaka Province participated (N = 11). The survey was conducted between August 2014 and January 2015 and administered in-person at each facility. Data regarding the availability of inpatient, outpatient, and community-based palliative care services, palliative medications, and psychosocial supports was obtained at each facility. The reported results are descriptive in nature. Results: Although the need for palliative care services was recognized, many facilities (64%) lack palliative care policies and only 18% offer palliative care in a coordinated program. The majority of services are only available to inpatients and rarely include community-based programs. While all facilities had adequate supplies of acetaminophen, 82% reported unavailability of codeine and 45% reported no access to oral morphine. Conclusions: This assessment confirms the dearth of palliative care services across Zambia. Less than half of its provincial hospitals offer community- or home-based services and only 55% offer opioid analgesics. Immediate and substantial improvements in policy, drug procurement and distribution, and service expansion are needed to ensure high-quality palliative care is available throughout Zambia.