Health Facility - Household Nexus for Palliative Care among Adult Cancer Patients in Addis Ababa, Ethiopia

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Addis Abeba University


Background: Based on a world health organization report in 2020, over 56 million people are estimated requiring palliative care every year and of which 76% are from Low and Middle-income countries; where a majority of 67.1% are adults; of those, 69% of palliative care need is associated with non-communicable diseases, and only 14% of people who needs palliative care are currently receive it; mainly cancer accounts for 34% out of the non-communicable diseases in need of palliative care. The critical point in palliative care services is to ensure the continuum of care and address patient needs as they pass through the referral pathways between the community and facility-based palliative care services. Objective: To explore the nexus of health facility and household palliative care for adult cancer patients in Addis Ababa Ethiopia. Method: Qualitative study was conducted in Addis Ababa from August 01- September 30, 2020. The investigator conducted an in-depth and key informant interviews through an open ended interview guide. Data were audio-recorded, transcribed verbatim, and finally imported to Open code version 4.02 software for coding and analyzing. Tanahashi framework was adopted to classify and organize data according to the key themes, concepts, and emerging categories. Results: Twenty-five respondents participated in this study. The continuum of palliative care was described as the relation between hospitals and home-based palliative care whereas nongovernmental support the community and health facilities by hosting training; volunteers contributes a lot to the continuum of palliative care starts at household level respondents stated that volunteers, family members, hospital care providers, and neighbors are used as a connective plug for the continuum of palliative care. Conclusion: The continuum of palliative care mainly depends on volunteers, non-governmental organizations based in Addis Ababa which includes hospitals in the loop of continuity. However, volunteers link cancer patients from the community to home-based palliative care. Mainly shortage of pain relief medications, turnover of staff, shortage of educated personnel, was mentioned as a barrier to the continuum of palliative care whereas availability of national palliative care policy, working palliative team/group, and commitment were facilitators.



Nexus, Continuity, Continuum of care, palliative care, cancer, Addis Ababa