Palliative Care: Supporting Adult Cancer Patients in Ibadan, Nigeria

Abstract

Over 70% of adult cancer patients present late to hospital in Nigeria with devastating consequences. Yet, structured palliative care is only an emerging service in this country with population of over 160 million.Objective: To describe activities of the Ibadan palliative care group and review one year holistic care programme offered by the team to support patients and their families. Methodology:A retrospective study reviewed treatment notes of patients that were enrolled from January to December 2013. Information retrieved included bio-data, stage of cancer, presenting complaints, palliative care issues identified, services rendered, days on programme, outcome and challenges.Results: Structured Palliative care service consisting of hospital based care, day care and home based care commenced in 2008, being the first of such in Nigeria. The service was based at the University College Hospital, Ibadan and run in collaboration with Centre for Palliative care Nigeria, a non-governmental organization. 189 patients were seen within the year and 121 (64%) were adults with advanced cancer. There were 44 (36.4%) male and 77 (63.6%) female with age range 21 to 91 years. 89 (73.6%) had moderate to severe pain. Psychosocial issues were present in 73% and spiritual issues in 17.4%. Services that were offered despite major challenges of late referral and financial constraints provided pain and symptom control, counselling, education for patients and family, financial and spiritual support thus improving quality of life Conclusion: Patients and their families found that palliative care provided relief to pain and suffering. More can be achieved through training of more health professionals, increased public awareness of the services and government support.

Exploring organizational culture regarding provision and utilization of palliative care in a Nigerian context: An interpretive descriptive study

“…[ 6 ] Several studies have reported inadequate funding, limited availability of morphine, religious and cultural meaning-making, insufficient PC professionals, and inadequate professional and public knowledge of PC to be factors that have impacted on PC development in Nigeria. [ 7 8 9 10 11 ] Considering that PC is poorly developed in Nigeria,[ 12 ] there is a need for a nuanced and sophisticated understanding of the organizational culture, because this could reveal either cultural enablers or inhibitors that may be drawn upon, or eliminated, to improve PC practice.…”

Social and Health System Complexities Impacting on Decision-Making for Utilization of Oncology and Palliative Care in an African Context: A Qualitative Study

“…Many studies have uncovered obstacles to PC in an African context, such as too few health professionals with PC training and education; lack of training opportunities; poor knowledge of, and attitudes toward, PC; professionals and service-users' lack of awareness; inadequate opioids; lay meaning-making of cancer/care; and a lack of PC policies in most African countries. [4][5][6][7][8][9] The rising costs of chemotherapy, drug resistance, and insufficient radiotherapy machines are some of the recognized challenges of cancer care in poorly resourced countries. 10,11 In addition, patients with cancer experience not only physical problems but also cancer-related social difficulties that impact on their mental health and quality of life.…”

Cancer mortality trends among middle-aged men and women in Nigeria: data from the WHO cancer mortality database

“…Cancer treatments such as radiotherapy and chemotherapy are not generally available in the public health system [18]. Palliative care such as community/home care for people with advanced stage cancer is also not generally available [19].…”