Faculty of Improving Global Health, Thames Valley and Wessex Leadership Academy, Winchester.
Afr J Prim Health Care Fam Med. 2024 Jan 21;16(1):e1-e9. doi: 10.4102/phcfm.v16i1.4047.
Palliative care (PC) is a priority in South Africa, focussing on integrating PC into primary health care. Few examples exist showing how this is done. In 2018, a rural PC project was implemented, which subsequently evolved into an integrated service between the hospital and the community.
The aim was to review the PC project over 4 years.
The setting was the George subdistrict of the Garden Route district in South Africa. Community-based services were offered to all patients with PC needs by three non-governmental organisations who deliver home community-based care via community health workers. They were supplemented by primary health care clinics, an intermediate care facility and two hospitals.
This was a retrospective descriptive study. Inpatient ward round data and patient referrals between 2018 and 2022 were analysed using descriptive statistics. Variables included patient demographics, diagnosis, home visits and place of death.
A total of 819 patients were referred. Inpatients were reviewed on weekly ward rounds by a multidisciplinary team. The most common diagnosis was cancer (57%). Home visits enabled patient follow-ups, of which 152 were recorded.
The programme has become sustainable and integrated in the public healthcare system. Contributing factors included dedicated staff, using simple tools and continuous training. The findings may be useful to PC programmes in similar contexts elsewhere.Contribution: This work adds new knowledge to the field of PC in an underresourced rural healthcare environment in sub-Saharan Africa, by describing how system-wide integration of a new service was navigated to become sustainable.
缓和医疗（PC）是南非的优先事项，重点是将 PC 整合到初级卫生保健中。很少有例子表明这是如何做到的。2018 年，实施了一个农村 PC 项目，随后该项目演变为医院和社区之间的综合服务。
回顾该 PC 项目在 4 年内的发展情况。
该研究的设置是南非花园路线地区乔治分区。三个非政府组织向所有有 PC 需求的患者提供基于社区的服务，这些组织通过社区卫生工作者提供家庭社区护理。这些服务由初级保健诊所、中级护理设施和两家医院提供补充。
这是一项回顾性描述性研究。使用描述性统计方法分析了 2018 年至 2022 年间的住院病人查房数据和患者转诊情况。变量包括患者人口统计学特征、诊断、家访和死亡地点。
共转诊了 819 名患者。多学科团队每周进行一次住院病人查房。最常见的诊断是癌症（57%）。家访使患者能够接受随访，其中有 152 次记录在案。
该方案已在公共卫生保健系统中变得可持续和综合。促成因素包括敬业的员工、使用简单的工具和持续的培训。这些发现可能对其他类似背景下的 PC 项目有用。
本研究在撒哈拉以南非洲资源匮乏的农村医疗保健环境中，对 PC 领域的新服务进行了系统范围的整合，以实现可持续性，为该领域增加了新知识。
