Five Ways Palliative Care in Rural Malawi Shows that Every Life Matters

Ratcliff, Cathy; Brough, Gary

doi:10.4997/jrcpe.2020.122

Journal of the Royal College of Physicians of Edinburgh

2020

DOI: 10.4997/jrcpe.2020.122

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Five Ways Palliative Care in Rural Malawi Shows that Every Life Matters

Cathy Ratcliff¹,

Gary Brough

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Cited by 2 publications

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Palliative care in Malawi: a scoping review

Palumbo,

Tilly,

Namisango

et al. 2023

BMC Palliat Care

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Background Universal access to palliative care remains a distant goal in many low resource settings, despite the growing evidence of its benefits. The unmet need for palliative care is evident in Africa, but great strides in palliative care development have occurred in several African countries. Located in sub-Saharan Africa, Malawi has been regarded as an exemplar of progress in this area that is achievable in a low resource region. This scoping review examined the literature on the development and state of palliative care in Malawi according to the pillars of health care policy, medicine availability, education, implementation, research activity, and vitality of professionals and advocates. Methods A scoping review was conducted of the MEDLINE, Embase, Global Health, CINAHL, Web of Science and PsycINFO databases, as well as grey literature sources. Articles were included if they explored any aspect of palliative care in Malawi. Results 114 articles were identified that met the inclusion criteria. This literature shows that Malawi has implemented diverse strategies across all pillars to develop palliative care. These strategies include creating a national stand-alone palliative care policy; integrating palliative care into the curricula of healthcare professionals and developing training for diverse service providers; establishing systems for the procurement and distribution of opioids; implementing diverse models of palliative care service delivery; and launching a national palliative care association. Malawi has also generated local evidence to inform palliative care, but several research gaps were identified. Conclusions Malawi has made considerable progress in palliative care development, although initiatives are needed to improve medicine availability, access in rural areas, and socioeconomic support for patients and their families living with advanced disease. Culturally sensitive research is needed regarding the quality of palliative care and the impact of therapeutic interventions.

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Palliative care in Malawi: a scoping review

Palumbo,

Tilly,

Namisango

et al. 2023

BMC Palliat Care

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Comprehensive scoping review of palliative care development in Africa: recent advances and persistent gaps

Bastos,

Garralda,

Montero

et al. 2024

Front. Health Serv.

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Worldwide 56·8 million people need palliative care (PC), and Africa shows the highest demand. This study updates the 2017 review of African PC development, using a scoping review methodology based on Arksey and O'Malley's framework and the PRISMA-ScR checklist. The review was conducted across PUBMED, CINAHL, Embase, government websites, and the African PC Association Atlas, from 2017 to 2023, charting its progress using the new WHO framework for PC Development, which, in addition to Services, Education, Medicines, and Policies, two new dimensions were incorporated: Research and Empowerment of people and Communities. Of the 4.420 records, 118 met the inclusion criteria. Findings showed increased adult specialised services (n = 675), and 15 of 54 countries have paediatric services. Nonetheless, the ratio of services per population mostly remains under 0,10 per 100.000 inhabitants. PC education was included in undergraduate curricula in 29 countries; despite the rise in morphine availability (28 countries), median consumption remains under 3 mg/per capita/year, and 14 countries presented stand-alone policies. Publications on PC development increased, and 26 countries have National PC Associations. Notwithstanding progress since 2017, significant hurdles remain, highlighting the need for ongoing research and policy development to ensure equitable access to palliative care in Africa.

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Five Ways Palliative Care in Rural Malawi Shows that Every Life Matters

Cited by 2 publications

References 3 publications

Palliative care in Malawi: a scoping review

Palliative care in Malawi: a scoping review

Comprehensive scoping review of palliative care development in Africa: recent advances and persistent gaps

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