The beginnings of children's palliative care in Africa: evaluation of a children's palliative care service in Africa.
OBJECTIVE
To evaluate a children's palliative care service designed specifically for a resource-poor sub-Saharan African setting.


METHODS
The study used mixed quantitative and qualitative methodology: quantitative retrospective, comparative survey and cross-sectional, noninterventional interview survey.


RESULTS
Evaluation showed increases in referrals, proportion of children on program, morphine and chemotherapy prescriptions, and improved compliance for a cost of $100 per child. The most valued service strengths were free drugs, food, play, learning, and staff attitude. Weaknesses included insufficiency of strengths listed above, as well as poor hospital staff attitude, lack of school fees and poor treatment compliance rates. Suggestions included more of the strengths as well as more accessible service locations.


CONCLUSIONS
The study suggests affordable, nurse-led, volunteer-supported children's palliative care services are both achievable and effective in sub-Saharan African. The study suggests that palliative care units should provide a specialized service focused on children. Such a service would clearly identify children in need of children's palliative care and should provide medication for symptom control; food and basic needs support; play and learning facilities; child protection; and systems for patient education, communication and follow up. Staff lack confidence and/or competence and this is a significant barrier to children's palliative care that should be addressed in Africa.
Amery
Justin M
JM
Hospice Africa Uganda, Kampala, Uganda. justin@amery.org
Rose
Caroline J
CJ
Holmes
Jennie
J
Nguyen
Jerry
J
Byarugaba
Charles
C
D017954:Africa South of the Sahara; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D010166:Palliative Care / Q000191:economics / Q000379:methods / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D011203:Poverty; D012189:Retrospective Studies