OncoAfrica

What Is Palliative Care?

Date: 30th September 2024 | Issue #2

elliot.abbot@cancerresearchkenya.org

Palliative care is a specialized medical approach focused on relieving symptoms, pain, and stress in patients with serious illnesses. Its primary goal is to enhance the quality of life for both patients and their families, regardless of the stage of the illness. The need for palliative care in Sub-Saharan Africa (SSA) is high yet many countries on the continent have no identifiable hospice or palliative care services integrated in their healthcare systems. This is despite SSA having the highest burden of chronic diseases such as HIV/AIDS, diabetes, chronic respiratory disease, and cancer.

In Kenya, late diagnosis of cancer often means that patients present with advanced stages of the disease, where curative treatments are less effective. This increases the need for palliative care to manage severe symptoms, control pain, and provide psychosocial support, ultimately improving the quality of life for patients and their families. Despite being a relatively new concept in Kenya, the demand for palliative care is overwhelming given the high burden of acute infectious diseases and non-communicable diseases like cancer. Kenya’s Ministry of Health data shows that over 800,000 Kenyans require palliative care annually, yet less than 15,000 receive these services.

Despite its importance, palliative care faces significant cultural barriers in Kenya, impacting its accessibility and acceptance. In many communities, serious illnesses, especially cancer, are stigmatized, leading patients and families to avoid palliative care services to prevent social ostracism. There is a common misconception that palliative care is only for the dying, causing reluctance to seek these services, as many believe it means giving up hope for recovery. Nonetheless, through the Kenya Hospices and Palliative Care Association (KEHPCA), there is a multifaceted approach towards sensitizing patients with chronic diseases, their families, and the general public about the value of palliative care. 

Additionally, a significant portion of the Kenyan population relies on traditional healers and remedies, which can delay or prevent the utilization of modern palliative care services. Some communities living in remote parts of Kenya believe illnesses are caused by supernatural forces or divine punishment, preferring spiritual healing over medical interventions, including palliative care. In such communities, healthcare decisions are often made collectively by the family rather than by the individual patient, complicating or delaying decisions about seeking palliative care. Traditional gender roles can also influence access, with women sometimes having less autonomy in making healthcare decisions and facing barriers in accessing services due to dependency on male family members.

There is also a widespread lack of awareness about what palliative care entails and its benefits. Many people are unfamiliar with the concept and thus do not seek out these services. This is because palliative care is a relatively new concept in Africa with evidence informing its delivery and quality borrowed from high-income countries where it is integrated in the healthcare system. Therefore, increasing awareness through community outreach programs can help dispel myths and educate people about the benefits of palliative care. Organizations like ICRF-Kenya aim to bolster awareness through outreach events, social media posts, webinars, and research into cancer care engagement. Stronger advocacy and policies that promote palliative care can help overcome these cultural barriers. Training healthcare providers on cultural competence and collaborating with traditional healers to incorporate culturally sensitive practices can bridge the gap between traditional beliefs and modern palliative care.

Palliative care is increasingly recognized as essential in Kenya’s healthcare system, particularly for common chronic conditions like cancer and HIV/AIDS. Key aspects include the availability of services through hospitals, NGOs, and community health programs, though access is limited in rural areas. Organizations like KEHPCA train healthcare providers and advocate for palliative care integration. The government includes palliative care in strategies like the National Cancer Control Strategy.

In conclusion, palliative care is crucial for improving the quality of life for patients with chronic diseases such as cancer and diabetes. Continued efforts to expand access, train providers, and raise awareness are necessary to ensure comprehensive and compassionate care for all patients. However, such services are only useful if the public is aware of their presence and benefits.

Dr. Elliot Abbot is the Chief Operating Officer at Integrated Cancer Research Foundation of Kenya.