Integrating Palliative Care At All Levels Of Health Care
Integrating palliative care at all levels of health care
Ideally palliative care should be available at all levels, from health facility to community to home. Integration takes place where the providers are in order to promote comprehensive services, avoid vertical programmes, share the work and promote quality of care. Areas where integration can take place include: Palliative care and prevention, treatment of HIV and AIDS related diseases, ART, primary health care, PMTCT/PPTCT, TB care services, needs of orphans and vulnerable children and the elderly.
hospaz bvumbamira vana (hbv)ovc project
HOSPAZ together with its two sub-partners Pamuhacha HIV Prevention Project and Tsungirirai Welfare Organization is implementing the activity “Sustaining Prevention, Care and Support Services for Orphans and Vulnerable Children (OVC) in Zimbabwe” The project’s goal is to improve health, safety, education and stability outcomes for orphans and other vulnerable children, adolescents, and youth affected and infected by HIV in Zimbabwe focusing on Makonde, Hurungwe, Chegutu and Zvimba Districts. The main goal will be achieved through improving access to HIV care and treatment services, strengthening child and family safety skills, improving economic stability and educational attainment for children adolescents and youth as well as strengthening local systems for planning, monitoring, and assuring quality of services for vulnerable children and their families. The HBV project will deliberately target OVC priority populations with an elevated risk of HIV namely children and adolescents living with HIV, child survivors of sexual violence (SVAC), HIV Exposed Infants, children of female sex workers, biological children of PLHIV, children who have been orphaned due to HIV, OVC caregivers and 9-14-year-old boys and girls living in communities with high HIV, violence, and school dropout prevalence.
The Zimbabwe Multiple Myeloma Program is part of the Global Cancer Disparities Africa Collaboration for Multiple Myeloma Grant receiving support from Bristol Myers Squibb Foundation (BMSF). The project is being implemented by a consortium of partners including – HOSPAZ, Zichire, UZ Haematology department, Cancer Association of Zimbabwe, and Jointed Hands Welfare Organization (JHWO). Due to the numerous ways that it presents for different patients, Multiple Myeloma is a little-known and often missed cancer in Zimbabwe. The project goal is to improve community awareness of multiple myeloma, strengthen health systems for the provision of Multiple Myeloma care and support services, and improve practice for early diagnosis, palliative care and survivorship. HOSPAZ as per its national mandate, is working towards improving access to high-quality, person-centred palliative care using capacity-strengthening interventions as its main strategy. HOSPAZ will periodically conduct mentorship support for the previously trained Palliative Care practitioners who include doctors, nurses, tutors, and other palliative care champions drawn from the central and provincial hospitals and project consortium partners in three highest burden areas namely - Harare, Bulawayo and Mashonaland East provinces. These were selected based on myeloma incidence data received from National Cancer Registry also considering their high burden in cancers, HIV co-infections and sub-optimum treatment success rates.
Palliative Care Integration (PCI) project
This project is supported by the True Colours Trust grant held by Island Hospice and Healthcare, it is implemented in collaboration with Ministry of Health and Child Care (MOHCC). The main goal of this project is to promote the integration of palliative care into Zimbabwe’s national health system. As the project’s secretariat, HOSPAZ’s role in line with its national mandate is to monitor palliative care standards, and to create provincial PC centres of excellence from among its members.
The project was initiated to address the urgent need to improve equitable access to holistic management of patients with life-threatening conditions in the national health system in Zimbabwe.
This followed evidence of need as reflected by the high burden of both non-communicable and communicable conditions against low and isolated provision of PC services. (Zimbabwe Policy and Gap Analysis for PC (2019).
PC service provision had been mainly through isolated private providers with minimal structured delivery in public health institutions.
Targeting of patients limited to those with terminal conditions (such as those with advanced cancer) as opposed to adopting PC as holistic quality care that can be provided to numerous conditions that are life-threatening, and introduced at the time of diagnosis.
Limited access to essential pain medicines due to the existing legal framework, which restricted prescribing of morphine to doctors.
Education in palliative care limited to in-service training by existing providers, whose curriculum focused on palliative care as end-of-life care and not as a continuum of care that is provided upon diagnosis of a life-threatening condition.
In order to increase access to Palliative Care services, a total of 6 HOSPAZ member organizations were identified within 6 provinces, and are currently having their capacity strengthened to function as PC centres of excellence that will support provision of PC by other HOSPAZ members in their provinces.