Measuring palliative care integration in Malawi through service provision, access, and training indicators: the Waterloo Coalition Initiative
Abstract Background Fewer than 1 in 20 people on the African continent in need of palliative care receive it. Malawi is a low-income country in sub-Saharan Africa that has yet to achieve advanced palliative care integration accompanied by unrestricted access to pain and symptom relieving palliative...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
|
| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-023-01331-0 |
| _version_ | 1797349674141614080 |
|---|---|
| author | Fatia Kiyange Mackuline Atieno Emmanuel B. K. Luyirika Zipporah Ali Helena Musau Lameck Thambo John Y. Rhee Eve Namisango William E. Rosa |
| author_facet | Fatia Kiyange Mackuline Atieno Emmanuel B. K. Luyirika Zipporah Ali Helena Musau Lameck Thambo John Y. Rhee Eve Namisango William E. Rosa |
| author_sort | Fatia Kiyange |
| collection | DOAJ |
| description | Abstract Background Fewer than 1 in 20 people on the African continent in need of palliative care receive it. Malawi is a low-income country in sub-Saharan Africa that has yet to achieve advanced palliative care integration accompanied by unrestricted access to pain and symptom relieving palliative medicines. This paper studied the impact of Malawi’s Waterloo Coalition Initiative (WCI) – a local project promoting palliative care integration through service development, staff training, and increased service access. Methods Interdisciplinary health professionals at 13 hospitals in southern Malawi were provided robust palliative care training over a 10-month period. We used a cross-sectional evaluation to measure palliative care integration based on 11 consensus-based indicators over a one-year period. Results 92% of hospitals made significant progress in all 11 indicators. Specifically, there was a 69% increase in the number of dedicated palliative care rooms/clinics, a total of 253 staff trained across all hospitals (a 220% increase in the region), substantive increases in the number of patients receiving or assessed for palliative care, and the number of hospitals that maintained access to morphine or other opioid analgesics while increasing the proportion of referrals to hospice or other palliative care programs. Conclusion Palliative care is a component of universal health coverage and Sustainable Development Goal 3. The WCI has made tremendous strides in establishing and integrating palliative care services in Malawi with notable progress across 11 project indicators, demonstrating that increased palliative care access is possible in severely resource-constrained settings through sustained models of partnership at the local level. |
| first_indexed | 2024-03-08T12:33:48Z |
| format | Article |
| id | doaj.art-cddebb0cc0214daa8c7337d3af1d1644 |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-03-08T12:33:48Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-cddebb0cc0214daa8c7337d3af1d16442024-01-21T12:39:34ZengBMCBMC Palliative Care1472-684X2024-01-0123111110.1186/s12904-023-01331-0Measuring palliative care integration in Malawi through service provision, access, and training indicators: the Waterloo Coalition InitiativeFatia Kiyange0Mackuline Atieno1Emmanuel B. K. Luyirika2Zipporah Ali3Helena Musau4Lameck Thambo5John Y. Rhee6Eve Namisango7William E. Rosa8African Palliative Care AssociationKenya Hospice and Palliative Care AssociationAfrican Palliative Care AssociationKenya Hospice and Palliative Care AssociationKenya Hospice and Palliative Care AssociationPalliative Care Association of MalawiDana-Farber Cancer InstituteAfrican Palliative Care AssociationDepartment of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer CenterAbstract Background Fewer than 1 in 20 people on the African continent in need of palliative care receive it. Malawi is a low-income country in sub-Saharan Africa that has yet to achieve advanced palliative care integration accompanied by unrestricted access to pain and symptom relieving palliative medicines. This paper studied the impact of Malawi’s Waterloo Coalition Initiative (WCI) – a local project promoting palliative care integration through service development, staff training, and increased service access. Methods Interdisciplinary health professionals at 13 hospitals in southern Malawi were provided robust palliative care training over a 10-month period. We used a cross-sectional evaluation to measure palliative care integration based on 11 consensus-based indicators over a one-year period. Results 92% of hospitals made significant progress in all 11 indicators. Specifically, there was a 69% increase in the number of dedicated palliative care rooms/clinics, a total of 253 staff trained across all hospitals (a 220% increase in the region), substantive increases in the number of patients receiving or assessed for palliative care, and the number of hospitals that maintained access to morphine or other opioid analgesics while increasing the proportion of referrals to hospice or other palliative care programs. Conclusion Palliative care is a component of universal health coverage and Sustainable Development Goal 3. The WCI has made tremendous strides in establishing and integrating palliative care services in Malawi with notable progress across 11 project indicators, demonstrating that increased palliative care access is possible in severely resource-constrained settings through sustained models of partnership at the local level.https://doi.org/10.1186/s12904-023-01331-0Palliative carePrimary palliative careMorphinePain reliefMalawiLMIC |
| spellingShingle | Fatia Kiyange Mackuline Atieno Emmanuel B. K. Luyirika Zipporah Ali Helena Musau Lameck Thambo John Y. Rhee Eve Namisango William E. Rosa Measuring palliative care integration in Malawi through service provision, access, and training indicators: the Waterloo Coalition Initiative BMC Palliative Care Palliative care Primary palliative care Morphine Pain relief Malawi LMIC |
| title | Measuring palliative care integration in Malawi through service provision, access, and training indicators: the Waterloo Coalition Initiative |
| title_full | Measuring palliative care integration in Malawi through service provision, access, and training indicators: the Waterloo Coalition Initiative |
| title_fullStr | Measuring palliative care integration in Malawi through service provision, access, and training indicators: the Waterloo Coalition Initiative |
| title_full_unstemmed | Measuring palliative care integration in Malawi through service provision, access, and training indicators: the Waterloo Coalition Initiative |
| title_short | Measuring palliative care integration in Malawi through service provision, access, and training indicators: the Waterloo Coalition Initiative |
| title_sort | measuring palliative care integration in malawi through service provision access and training indicators the waterloo coalition initiative |
| topic | Palliative care Primary palliative care Morphine Pain relief Malawi LMIC |
| url | https://doi.org/10.1186/s12904-023-01331-0 |
| work_keys_str_mv | AT fatiakiyange measuringpalliativecareintegrationinmalawithroughserviceprovisionaccessandtrainingindicatorsthewaterloocoalitioninitiative AT mackulineatieno measuringpalliativecareintegrationinmalawithroughserviceprovisionaccessandtrainingindicatorsthewaterloocoalitioninitiative AT emmanuelbkluyirika measuringpalliativecareintegrationinmalawithroughserviceprovisionaccessandtrainingindicatorsthewaterloocoalitioninitiative AT zipporahali measuringpalliativecareintegrationinmalawithroughserviceprovisionaccessandtrainingindicatorsthewaterloocoalitioninitiative AT helenamusau measuringpalliativecareintegrationinmalawithroughserviceprovisionaccessandtrainingindicatorsthewaterloocoalitioninitiative AT lameckthambo measuringpalliativecareintegrationinmalawithroughserviceprovisionaccessandtrainingindicatorsthewaterloocoalitioninitiative AT johnyrhee measuringpalliativecareintegrationinmalawithroughserviceprovisionaccessandtrainingindicatorsthewaterloocoalitioninitiative AT evenamisango measuringpalliativecareintegrationinmalawithroughserviceprovisionaccessandtrainingindicatorsthewaterloocoalitioninitiative AT williamerosa measuringpalliativecareintegrationinmalawithroughserviceprovisionaccessandtrainingindicatorsthewaterloocoalitioninitiative |