Millions in dire need of palliative care

According to the World Health Organisation (WHO) most of whom live in low- and middle-income countries. For children, 98% of those needing palliative care live in low- and middle-income countries with almost half of them living in Africa. Worldwide, a number of significant barriers must be overcome to address the unmet need for palliative care: national health policies and systems often do not include palliative care at all; training on palliative care for health professionals is often limited or non-existent; and population access to opioid pain relief is inadequate and fails to meet international conventions on access to essential medicines.

According to a WHO survey relating to noncommunicable diseases conducted among 194 Member States in 2019: funding for palliative care was available in 68% of countries and only 40% of countries reported that the services reached at least half of patients in need.

The International Narcotics Control Board found that in 2018, 79 per cent of the world’s population, mainly people in low- and middle-income countries, consumed only 13 per cent of the total amount of morphine used for the management of pain and suffering, or 1 per cent of the 388 tons of morphine manufactured worldwide. Although that was an improvement over 2014, when 80 per cent of the world’s population consumed only 9.5 per cent of the morphine used for the management of pain and suffering, the disparity in the consumption of narcotic drugs for palliative care between low- and middle-income countries and high-income countries continues to be a matter of concern.

Other barriers to palliative care include:

lack of awareness among policy-makers, health professionals and the public about what palliative care is, and the benefits it can offer patients and health systems;

cultural and social barriers, such as beliefs about death and dying;

misconceptions about palliative care, such as that it is only for patients with cancer, or for the last weeks of life; and

misconceptions that improving access to opioid analgesia will lead to increased substance abuse.

Palliative care is most effective when considered early in the course of the illness. Early palliative care not only improves quality of life for patients but also reduces unnecessary hospitalizations and use of health-care services.

Palliative care needs to be provided in accordance with the principles of universal health coverage. All people, irrespective of income, disease type or age, should have access to a nationally- determined set of basic health services, including palliative care. Financial and social protection systems need to take into account the human right to palliative care for poor and marginalized population groups.

As part of multidisciplinary teams, the nursing workforce should be trained in palliative care skills, especially those who work with patients with serious illness.

Specialist palliative care is one component of palliative care service delivery. But a sustainable, quality and accessible palliative care system needs to be integrated into primary health care, community and home-based care, as well as supporting care providers such as family and community volunteers. Providing palliative care should be considered an ethical duty for health professionals.

In Namibia the Cancer Association of Namibia established Palliative Care Namibia from the need to drive quality palliative care and policy thereto, for the benefit of not only cancer patients, but all Namibians in need of this very important health discipline.

According to CAN’s chief executive officer Rolf Hansen, the focus is to contribute to a Namibian healthcare ecosystem where quality palliative care services are developed, supported, and integrated, ensuring that all Namibian patients in need have access to compassionate, holistic care.

“The mission is to foster a national commitment to palliative and hospice care, advocating for a patient-centered approach that empowers patient autonomy. We aim to promote an interdisciplinary team approach to care, ensuring that palliation and hospice care services provide comprehensive support to patients and their families,” he explained.

Given these goals, and understanding the expanded landscape needs since officially opening, CAN has now both Hospice and Sub Acute registration, in addition to Nursing and Clinic registration.

“We recommit ourselves to help tackle the national burden of Cancer, Palliative Care, Rare Diseases and Non-Commununicable Diseases with stakeholders, to the benefit of our community.”

Facebook: Palliative Care Namibia; 3 Jan Jonker Road, Klein Windhoek; all calls via the national switchboard - choose Palliative Care Namibia : 0819537740. For general information, visit or medical teams wishing to view or connect: [email protected]. For patient transfers from existing medical units and/or doctors to ours; and/or interdisciplinary planning: [email protected]

*Please note that scheduled transfers and admissions take place Monday through Friday only. PCN conforms to the NAMAF Tarrif Schedule, and there is not an "average rate" to stay at our in-patient unit. Each patient has different needs, and subject to the medical needs, a comprehensive Unique Care Plan must be planned. We encourage patients, their loved ones and their medical team to reach out to us, have a round-table discussion at our House Zietsman PCN unit, and together find the best personalised care plan.





Did you know?

Aim

Relief of symptoms is one of the major aims of the palliative care team.



STATS:

Common palliative symptoms

*Pain

*Constipation

*Nausea

*Tiredness

*Breathlessness

*Fatigue

*Delirium