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Current HIV/AIDS end-of-life care in sub-Saharan Africa: a survey of models, services, challenges and priorities

BACKGROUND: In response to increased global public health funding initiatives to HIV/AIDS care in Africa, this study aimed to describe practice models, strategies and challenges to delivering end-of-life care in sub-Saharan Africa. METHODS: A survey end-of-life care programs was conducted, addressin...

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Autores principales: Harding, Richard, Stewart, Karen, Marconi, Katherine, O'Neill, Joseph F, Higginson, Irene J
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2003
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC280683/
https://www.ncbi.nlm.nih.gov/pubmed/14572317
http://dx.doi.org/10.1186/1471-2458-3-33
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author Harding, Richard
Stewart, Karen
Marconi, Katherine
O'Neill, Joseph F
Higginson, Irene J
author_facet Harding, Richard
Stewart, Karen
Marconi, Katherine
O'Neill, Joseph F
Higginson, Irene J
author_sort Harding, Richard
collection PubMed
description BACKGROUND: In response to increased global public health funding initiatives to HIV/AIDS care in Africa, this study aimed to describe practice models, strategies and challenges to delivering end-of-life care in sub-Saharan Africa. METHODS: A survey end-of-life care programs was conducted, addressing the domains of service aims and configuration, barriers to pain control, governmental endorsement and strategies, funding, monitoring and evaluation, and research. Both closed and qualitative responses were sought. RESULTS: Despite great structural challenges, data from 48 programs in 14 countries with a mean annual funding of US $374,884 demonstrated integrated care delivery across diverse settings. Care was commonly integrated with all advanced disease care (67%) and disease stages (65% offering care from diagnosis). The majority (98%) provided home-based care for a mean of 301 patients. Ninety-four percent reported challenges in pain control (including availability, lack of trained providers, stigma and legal restrictions), and 77% addressed the effects of poverty on disease progression and management. Although 85% of programs reported Government endorsement, end-of-life and palliative care National strategies were largely absent. CONCLUSIONS: The interdependent tasks of expanding pain control, balancing quality and coverage of care, providing technical assistance in monitoring and evaluation, collaborating between donor agencies and governments, and educating policy makers and program directors of end-of-life care are all necessary if resources are to reach their goals.
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spelling pubmed-2806832003-12-02 Current HIV/AIDS end-of-life care in sub-Saharan Africa: a survey of models, services, challenges and priorities Harding, Richard Stewart, Karen Marconi, Katherine O'Neill, Joseph F Higginson, Irene J BMC Public Health Research Article BACKGROUND: In response to increased global public health funding initiatives to HIV/AIDS care in Africa, this study aimed to describe practice models, strategies and challenges to delivering end-of-life care in sub-Saharan Africa. METHODS: A survey end-of-life care programs was conducted, addressing the domains of service aims and configuration, barriers to pain control, governmental endorsement and strategies, funding, monitoring and evaluation, and research. Both closed and qualitative responses were sought. RESULTS: Despite great structural challenges, data from 48 programs in 14 countries with a mean annual funding of US $374,884 demonstrated integrated care delivery across diverse settings. Care was commonly integrated with all advanced disease care (67%) and disease stages (65% offering care from diagnosis). The majority (98%) provided home-based care for a mean of 301 patients. Ninety-four percent reported challenges in pain control (including availability, lack of trained providers, stigma and legal restrictions), and 77% addressed the effects of poverty on disease progression and management. Although 85% of programs reported Government endorsement, end-of-life and palliative care National strategies were largely absent. CONCLUSIONS: The interdependent tasks of expanding pain control, balancing quality and coverage of care, providing technical assistance in monitoring and evaluation, collaborating between donor agencies and governments, and educating policy makers and program directors of end-of-life care are all necessary if resources are to reach their goals. BioMed Central 2003-10-23 /pmc/articles/PMC280683/ /pubmed/14572317 http://dx.doi.org/10.1186/1471-2458-3-33 Text en Copyright © 2003 Harding et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
spellingShingle Research Article
Harding, Richard
Stewart, Karen
Marconi, Katherine
O'Neill, Joseph F
Higginson, Irene J
Current HIV/AIDS end-of-life care in sub-Saharan Africa: a survey of models, services, challenges and priorities
title Current HIV/AIDS end-of-life care in sub-Saharan Africa: a survey of models, services, challenges and priorities
title_full Current HIV/AIDS end-of-life care in sub-Saharan Africa: a survey of models, services, challenges and priorities
title_fullStr Current HIV/AIDS end-of-life care in sub-Saharan Africa: a survey of models, services, challenges and priorities
title_full_unstemmed Current HIV/AIDS end-of-life care in sub-Saharan Africa: a survey of models, services, challenges and priorities
title_short Current HIV/AIDS end-of-life care in sub-Saharan Africa: a survey of models, services, challenges and priorities
title_sort current hiv/aids end-of-life care in sub-saharan africa: a survey of models, services, challenges and priorities
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC280683/
https://www.ncbi.nlm.nih.gov/pubmed/14572317
http://dx.doi.org/10.1186/1471-2458-3-33
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