As the world marked the Hospice and Palliative Care Day on Saturday, October 12, it emerged there was need to appreciate the applicability of this service to the realisation of quality healthcare and its importance in Universal Health Coverage (UHC).
This year’s theme, Palliative Care: it’s “My Care, My Right, fits well with Kenya’s Health Act 2017, 5 (1), which states that every person has the right to the highest attainable standard of health which shall include progressive access for provision of promotive, preventive, curative, palliative and rehabilitative services. The goal of palliative care is to improve quality of life for both the patient and their family.
Many people are suffering from chronic non-communicable diseases (NCDs) in Kenya and globally. Primary care-led management of these chronic diseases, including palliative care, is essential to deliver cost-effective UHC that does not impose financial hardships on people with NCDs.
Efforts to achieve primary care-led UHC provide an opportunity to ensure that palliative care is being delivered at the primary care level and all other stages of care from level one to level six hospitals. The aim is a holistic approach to care for patients and families, coordination of care, and person-centred care within a wider context.
SUSTAINABLE DEVELOPMENT GOAL
The theme, My Care, My Right, means that palliative care can be a subject of sabotage by the public, even though it is a right. Therefore, a key action for the campaign is calling on governments to support the inclusion of the essential package of palliative care in all national UHC discussions, policies and schemes.
In addition, this theme also means that communities need to ensure that patient’s rights to care are supported. Specifically addressing the premise that if care is a patient's right, how can UHC support the care givers to improve their well-being under Sustainable Development Goals.
To achieve this, all cadres of clinicians require clinical competencies and resources. This is especially limited in our setting and it is high time that clinicians are trained and appreciate the role palliative care plays in healthcare delivery.
Palliative care is provided by multidisciplinary teams which include doctors, nurses, counsellors, spiritual care givers, nutritionists, pharmacists, family members and volunteers. These teams work with patients and their families to clarify the goals of care and provide symptom management, psychosocial and spiritual support.
Palliative care is appropriate at any age and stage of a serious illness and can be provided as the main goal of care or along with curative treatment. Although it is a key part of end-of-life care, it is not limited to that stage, a common misconception among healthcare workers and the public. This challenges palliative care professionals in providing timely services as patients are referred to them late.
Palliative care can be provided across multiple settings including in hospitals, at home, as part of community palliative care programmes and in skilled nursing facilities. Thus, the scope of palliative care within healthcare systems is wide and its development is vital to enable realisation of UHC globally and the Big Four agenda in Kenya.
Dr Weru is an assistant professor and consultant palliative physician at Aga Khan University Hospital