Icahn School of Medicine at Mount Sinai, New York, New York, USA; ATLANTES Research Program, Institute for Culture and Society, University of Navarra, Pamplona, Spain.
ATLANTES Research Program, Institute for Culture and Society, University of Navarra, Pamplona, Spain; IdiSNA (Instituto de Investigación Sanitaria de Navarra/Institute of Health Research of Navarra), Pamplona, Spain.
J Pain Symptom Manage. 2018 Aug;56(2):230-238. doi: 10.1016/j.jpainsymman.2018.05.005. Epub 2018 May 22.
To date, there is no study comparing palliative care (PC) development among African countries.
To analyze comparatively PC development in African countries based on region-specific indicators.
Data were obtained from the African PC Association Atlas of PC in Africa, and a comparative analysis was conducted. Nineteen indicators were developed and defined through qualitative interviews with African PC experts and a two-round modified Delphi consensus process with international experts on global PC indicators. Indicators were grouped by the World Health Organization public health strategy for PC dimensions. These indicators were then sent as a survey to key informants in 52 of 54 African countries. Through an expert weighting process and ratings from the modified Delphi, weights were assigned to each indicator.
Surveys were received from 89% (48 of 54) of African countries. The top three countries in overall PC development were, in order, Uganda, South Africa, and Kenya. Variability existed by dimension. The top three countries in specialized services were Uganda, South Africa, and Nigeria; in policies, it was Botswana followed by parity among Ethiopia, Rwanda, and Swaziland; in medicines, it was Swaziland, South Africa, then Malawi; and in education, it was equivalent between Uganda and Kenya, then Ghana and Zambia.
Uganda, South Africa, and Kenya are the highest performing countries and were the only ones with composite scores greater than 0.5 (50%). However, not one country universally supersedes all others across all four PC dimensions. The breakdown of rankings by dimension highlights where even high-performing African countries can focus their efforts to further PC development.
迄今为止，尚无研究比较非洲国家的姑息治疗（PC）发展情况。
基于区域特定指标，分析比较非洲国家的 PC 发展情况。
数据来自非洲姑息治疗协会的《非洲姑息治疗地图集》，并进行了比较分析。通过与非洲姑息治疗专家进行定性访谈以及对全球姑息治疗指标的国际专家进行两轮修订 Delphi 共识过程，制定并定义了 19 个指标。根据世界卫生组织姑息治疗公共卫生战略的维度对指标进行分组。然后将这些指标作为调查发送给 54 个非洲国家中的 52 个国家的主要信息提供者。通过专家加权过程和修订 Delphi 的评分，为每个指标分配权重。
收到了来自 54 个非洲国家中的 89%（48 个）的调查。总体 PC 发展排名前三的国家依次是乌干达、南非和肯尼亚。各维度存在差异。在专科服务方面排名前三的国家是乌干达、南非和尼日利亚；在政策方面，博茨瓦纳排名第一，其次是埃塞俄比亚、卢旺达和斯威士兰之间的平等；在药品方面，斯威士兰、南非、然后是马拉维；在教育方面，乌干达和肯尼亚持平，其次是加纳和赞比亚。
乌干达、南非和肯尼亚是表现最好的国家，也是唯一综合得分大于 0.5（50%）的国家。然而，没有一个国家在所有四个 PC 维度上都普遍优于所有其他国家。按维度细分的排名突出了即使是表现出色的非洲国家也可以集中精力进一步发展 PC。
