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One year on: The APCA Atlas of Palliative Care in Africa, Featuring Botswana

Author: : Rhee, J.Y. (John Y.) Luyirika, E. (Emmanuel) Namisango, E. (Eve) Powell, R.A. (Richard A.) Garralda, E. (Eduardo) Pons-Izquierdo, J.J. (Juan José) Lima, L. (Liliana) de Centeno-Cortes, C. (Carlos)
22 May 2018
  • Former Minister for Health for the Gambia Dr Cherno Omar Barry and Vice president National PC Association The Gambia Jerreh K Drammeh receive the Atlas from APCA staff Eve Namisango & Patricia Batanda.

May 2018 marks 1 year since the official launch of the APCA Atlas of Palliative Care in Africa (APCA Atlas), a resource that provides comprehensive information on the status of palliative care in Africa, with a country by country presentation of 48 of the 54 African countries that is based on a standard set of indicators.

The indicators were derived, rated, and chosen by in-country African experts working together with a panel of international experts, and are therefore specific to the African context.

The Atlas has been disseminated to stakeholders in most African countries, some of whom are using it to inform policies ,practice, and for advocacy efforts in working with governments and Ministries of Health.  The Atlas also provides benchmarks and credible background for future developments in palliative care and is a source of vital cross-country comparison information on the progress of palliative care in Africa. Progress can only be measured if the current state of development is known.

While palliative care is growing in African countries, the growth has been unevenly distributed hence the transparency of the APCA Atlas is facilitating the exchange of best practice cases.

The table below extracts typical indicators from the APCA Atlas, covering policies, education, medicines, and services in Botswana.

Country Information: Botswana

Stand-alone national palliative care (PC) plan/programme:          Yes

National cancer plan/programme with a section for PC:               Yes

National HIV plan/programme with a section for PC:                    Yes

National PC clinical guidelines:                                                     Yes

Person/desk/unit in the MOH with PC responsibility:                    Yes

Funding for PC in the National Health budget:                           Yes

Hospitals with inpatient PC units:                                                  8% (3/40)

Number of medical schools:                                                          1

Medical schools which include PC education as mandatory:        0% (0/1)

Availability of immediate-release moral morphine:                        Yes

Non-specialised physicians can prescribe morphine:                    No

Number of nursing schools:                                                            7

Nursing schools which include PC education as mandatory:        86% (6/7)

Trained nurses can prescribe morphine:                                       No

Hospitals with inpatient PC units:                                                  8% (3/40)

Number of home-based PC services (offered by hospices):         3

Districts with at least one PC service:                                           15% (4/27)

Existence of a national association or equivalent for PC:             Yes

Existence of a periodic national conference for PC:                     No

Number of hospices or PC services:                                             4

Number of hospices or PC services with

paediatric-specific programmes:                                                   25% (1/4)

Number of PC cared for in the last year (estimation):                  3210

With baseline information such as this, palliative care stakeholders and authorities are clearly guided on what areas need further development to ensure that palliative care is fully integrated into their health systems.

This and more essential country by country information can be accessed here

The Atlas was produced through a partnership among the following institutions: the African Palliative Care Association, the International Association for Hospice and Palliative Care, the Icahn School of Medicine at Mount Sinai, and the ATLANTES Research Program at the Institute for Culture and Society of the University of Navarra.

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