title: Research into palliative care in sub-Saharan Africa.
abstract: Roughly half a million people die of cancer in sub-Saharan Africa every year. Despite rapid expansion of palliative care for cancer, coverage remains woefully inadequate. The WHO public health strategy for palliative care aims to increase access to palliative care services through its integration into health-care systems. We present the available evidence for the four WHO strategy pillars of policy, education, drug availability, and implementation, and propose a fifth pillar of research activity to stimulate improvement of care. Increased attention to the generation of research evidence is essential to achieve quality and coverage of appropriate palliative care for patients with advanced cancer in sub-Saharan Africa. The use of locally validated, patient-reported outcome measures is an important advance in the measurement and improvement of care and patient wellbeing. Palliative care for patients with cancer in Africa currently receives far less research attention than does palliative care for patients with HIV/AIDS, but in view of projected increasing cancer incidence in the region, generation of local evidence to inform and allow assessment of palliative care for patients with cancer is urgently needed.
authors.affiliation: Cicely Saunders Institute, Department of Palliative Care, Policy & Rehabilitation, King's College London, London, UK. richard.harding@kcl.ac.uk
authors.forename: Richard
authors.initials: R
authors.lastname: Harding
authors.forename: Lucy
authors.initials: L
authors.lastname: Selman
authors.forename: Richard A
authors.initials: RA
authors.lastname: Powell
authors.forename: Eve
authors.initials: E
authors.lastname: Namisango
authors.forename: Julia
authors.initials: J
authors.lastname: Downing
authors.forename: Anne
authors.initials: A
authors.lastname: Merriman
authors.forename: Zipporah
authors.initials: Z
authors.lastname: Ali
authors.forename: Nancy
authors.initials: N
authors.lastname: Gikaara
authors.forename: Liz
authors.initials: L
authors.lastname: Gwyther
authors.forename: Irene
authors.initials: I
authors.lastname: Higginson
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D006301:Health Services Needs and Demand; D006801:Humans; D009369:Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D010166:Palliative Care; D011634:Public Health