African Palliative Care Association, Kampala, Uganda.
Kenya Hospice and Palliative Care Association, Nairobi, Kenya.
BMC Palliat Care. 2024 Jan 16;23(1):17. doi: 10.1186/s12904-023-01331-0.
Fewer than 1 in 20 people on the African continent in need of palliative care receive it. Malawi is a low-income country in sub-Saharan Africa that has yet to achieve advanced palliative care integration accompanied by unrestricted access to pain and symptom relieving palliative medicines. This paper studied the impact of Malawi's Waterloo Coalition Initiative (WCI) - a local project promoting palliative care integration through service development, staff training, and increased service access.
Interdisciplinary health professionals at 13 hospitals in southern Malawi were provided robust palliative care training over a 10-month period. We used a cross-sectional evaluation to measure palliative care integration based on 11 consensus-based indicators over a one-year period.
92% of hospitals made significant progress in all 11 indicators. Specifically, there was a 69% increase in the number of dedicated palliative care rooms/clinics, a total of 253 staff trained across all hospitals (a 220% increase in the region), substantive increases in the number of patients receiving or assessed for palliative care, and the number of hospitals that maintained access to morphine or other opioid analgesics while increasing the proportion of referrals to hospice or other palliative care programs.
Palliative care is a component of universal health coverage and Sustainable Development Goal 3. The WCI has made tremendous strides in establishing and integrating palliative care services in Malawi with notable progress across 11 project indicators, demonstrating that increased palliative care access is possible in severely resource-constrained settings through sustained models of partnership at the local level.
在非洲大陆，需要姑息治疗的人中，不到 1/20 能够得到姑息治疗。马拉维是撒哈拉以南非洲的一个低收入国家，尚未实现先进的姑息治疗整合，同时也无法无限制地获得缓解疼痛和症状的姑息治疗药物。本文研究了马拉维 Waterloo 联盟倡议（WCI）的影响 - 一个通过服务开发、员工培训和增加服务机会来促进姑息治疗整合的本地项目。
在马拉维南部的 13 家医院，跨学科的卫生专业人员接受了为期 10 个月的强化姑息治疗培训。我们使用横断面评估，在一年的时间内，根据 11 个基于共识的指标来衡量姑息治疗的整合情况。
92%的医院在所有 11 个指标上都取得了显著进展。具体来说，专门的姑息治疗室/诊所的数量增加了 69%，共有 253 名员工在所有医院接受了培训（该地区增加了 220%），接受或评估姑息治疗的患者数量显著增加，以及维持吗啡或其他阿片类镇痛药供应的医院数量增加，同时增加了临终关怀或其他姑息治疗项目的转诊比例。
姑息治疗是全民健康覆盖和可持续发展目标 3 的组成部分。WCI 在马拉维建立和整合姑息治疗服务方面取得了巨大进展，在 11 个项目指标上取得了显著进展，表明通过在地方一级建立可持续的伙伴关系模式，在资源严重受限的情况下，可以增加姑息治疗的可及性。
