title: Pediatric palliative care in sub-saharan Africa: a systematic review of the evidence for care models, interventions, and outcomes.
abstract: BACKGROUND
  The progressive disease burden among children in sub-Saharan Africa means the provision of palliative care is essential and should be provided alongside treatment where it is available.
  
  
  OBJECTIVE
  To systematically review the evidence for pediatric palliative care models, interventions, and outcomes to appraise the state of the science and inform best practice.
  
  
  METHODS
  A systematic review search strategy was implemented in eight electronic databases, the search results reported using a PRISMA statement, and findings tabulated.
  
  
  RESULTS
  In terms of evidence of palliative care provision and outcomes, only five articles were identified. These represent a small range of acute, community, and hospice care and offer some limited guidance on the development and delivery of services.
  
  
  CONCLUSIONS
  Pediatric palliative care is a pressing clinical and public health challenge in sub-Saharan Africa. Explicit evidence-based models of service development, patient assessment, and evidence for control of prevalent problems (physical, psychological, social, spiritual, and developmental) are urgently needed. Greater research activity is urgently required to ensure an evidence-based response to the enormous need for pediatric palliative care in sub-Saharan Africa.
authors: Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, United Kingdom. Electronic address: richard.harding@kcl.ac.uk.
authors: Richard
authors: R
authors: Harding
authors: Department of Paediatric Surgery, Red Cross Children's Hospital, Cape Town, South Africa.
authors: Rene
authors: R
authors: Albertyn
authors: Infection & Population Health, Institute of Epidemiology & Health, Faculty of Population Health Sciences, University College London, London, United Kingdom.
authors: Lorraine
authors: L
authors: Sherr
authors: Hospice Palliative Care Association of South Africa, Cape Town, South Africa; School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
authors: Liz
authors: L
authors: Gwyther
mesh_terms: D000293:Adolescent; D017954:Africa South of the Sahara; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D017051:Hospice Care / Q000379:methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010166:Palliative Care / Q000379:methods*; D010372:Pediatrics
keywords: Africa; HIV; Pediatric; cancer; palliative