Browsing by Author "Ali, Zipporah"

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    Progress Update: Palliative Care Development Between 2017 and 2020 in Five African Countries
    (Journal of Pain and Symptom Management, 2022) Luyirika, Emmanuel; Ali, Zipporah; Atieno, Mackuline; Mahenge, Anna; Muinga, Esther; Musyoki, David; Mwesiga, Mark Donald; Namisango, Eve; Opio, Geoffrey; Ruzima, Aimable; Zalwango, Joyce; Aluso, Aggrey
    This article provides a progress update on the development of palliative care in five countries in Africa—Kenya, Rwanda, South Africa, Tanzania, and Uganda—between 2017 and 2021, and explores the role of palliative care advocates and the Open Society Foundations in this process.To provide a progress update on the development of palliative care in Kenya, Rwanda, South Africa, Tanzania, and Uganda between 2017 and 2021 and to examine the impact of twenty years of Open Society Foundations support for palliative care in the region on the integration of palliative care into publicly funded health systems.In the mid-2000s, palliative care pioneers in these five countries, supported by Open Society Foundations, began to train health care providers and engage policy makers to ensure that people with life-limiting illnesses and their families had access to appropriate services and essential medicines. In the late 2010s, it embraced an approach that mixed strategic communications and advocacy for inclusion of palliative care into universal health coverage with technical assistance.By the mid-2010s, a vibrant palliative care community existed that worked closely with governments to develop palliative care policies, train providers, and ensure access to morphine. By 2021, Kenya and Rwanda had made significant progress scaling up palliative care services as part of the public health care system, and Uganda's government had instructed public hospitals to start providing these services. In South Africa and Tanzania, governments had yet to commit to publicly funded palliative care services.The experiences in these countries suggest that mixing advocacy, communications, and technical assistance can lead to substantial progress for patient access although full inclusion in universal health coverage remained uncertain in all but Rwanda.
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    Research intoPalliative Care in Sub-Saharan Africa
    (The Lancet Oncology, 2013) Harding, Richard; Selman, Lucy; Powell, Richard A.; Namisango, Eve; Ali, Zipporah; Gikaara, Nancy; Higginson, Irene
    Roughly half a million people die of cancer in sub-Saharan Africa every year. Despite rapid expansion of palliative care for cancer, coverage remains woefully inadequate. The WHO public health strategy for palliative care aims to increase access to palliative care services through its integration into health-care systems. We present the available evidence for the four WHO strategy pillars of policy, education, drug availability, and implementation, and propose a fifth pillar of research activity to stimulate improvement of care. Increased attention to the generation of research evidence is essential to achieve quality and coverage of appropriate palliative care for patients with advanced cancer in sub-Saharan Africa. The use of locally validated, patient-reported outcome measures is an important advance in the measurement and improvement of care and patient wellbeing. Palliative care for patients with cancer in Africa currently receives far less research attention than does palliative care for patients with HIV/AIDS, but in view of projected increasing cancer incidence in the region, generation of local evidence to inform and allow assessment of palliative care for patients with cancer is urgently needed.