Ntizimira Christian, Sebatunzi Osee, Mukeshimana Olive, Umutesi Viviane, Ngizwenayo Scholastique
Kibagabaga Hospital, Rawanda.
BMJ Support Palliat Care. 2015 Apr;5 Suppl 1:A17. doi: 10.1136/bmjspcare-2015-000906.55.
Multi-disciplinary palliative care for patients with any disease is rarely integrated into the public healthcare system at all levels in Africa. In Kigali, Rwanda, we have developed palliative care services in a district general hospital and linked these services to home care using community health workers. In addition, the Ministry of Health recently approved a palliative care training curriculum for community health workers employed by the government who will expand and make sustainable palliative home care.
The impact of Community health workers helped the district hospital to map patients with chronic diseases, palliative care and identify symptoms for better orientation.
At Kibagabaga Hospital, the public hospital for Gasabo District that includes 60% of the population of Kigali, we initiated a training of 481 community health workers (CHW), 1 CHW/per village for continuing care and retro-information to the District Palliative Care team through Health centre.
As of June 2014, community health workers had identified 432 patients and report has been sent to the district palliative care team for mapping. Anecdotal data indicates a high level of satisfaction by patients and family members with palliative care assisted at community level and a reduced stress of continuum care.
It is feasible to integrate palliative care for patients at community level into public healthcare systems in Africa using Community health workers.
针对患有任何疾病的患者的多学科姑息治疗在非洲各级公共医疗体系中几乎都未得到整合。在卢旺达基加利，我们在一家区级综合医院开展了姑息治疗服务，并通过社区卫生工作者将这些服务与家庭护理联系起来。此外，卫生部最近批准了一项针对受雇于政府的社区卫生工作者的姑息治疗培训课程，这些工作者将扩大并使姑息家庭护理得以持续。
社区卫生工作者的影响有助于区级医院对慢性病、姑息治疗患者进行排查，并识别症状以更好地开展工作。
在基巴加巴加医院（加萨博区的公立医院，服务于基加利60%的人口），我们启动了对481名社区卫生工作者的培训，每个村庄有1名社区卫生工作者，负责持续护理并通过健康中心向区级姑息治疗团队反馈信息。
截至2014年6月，社区卫生工作者已识别出432名患者，并将报告发送给区级姑息治疗团队进行排查。轶事数据表明，患者和家庭成员对社区层面提供的姑息治疗满意度很高，且连续护理的压力有所减轻。
利用社区卫生工作者将社区层面的患者姑息治疗整合到非洲的公共医疗体系中是可行的。
