The policy, launched this year, is one of the most progressive hospice and palliative care policies on the continent because it captures:

• the provision of the 2014 World Health Assembly Resolution on palliative care
• the essential services under Universal Health Coverage Declaration
• the UN Political Declaration on Non-Communicable Diseases
• and the African Union Common Position on Controlled Substances and Access to Pain Medications.

The policy has initiatives under each of the WHO Health Systems Building Blocks taking full responsibility on leadership to ensure the service is available at all levels within the health system while maintaining a multidisciplinary multi-stakeholder country palliative care team.

On financing, the government commits to increase financial investment at all levels as well as inclusion of palliative care into medical aid schemes. The government even commits to contribute financial resources to non-state hospice and palliative care providing organisations.

The policy’s development was funded by the American International Health Alliance (AIHA)/Twinning Center and the Centers for Disease Control and Prevention in Botswana. The policy development process was led and guided by the African Palliative Care Association (APCA).

Interested in viewing the policy? Email the African Palliative Care Association to receive a copy.

Policy launch 

The policy was officially launched to coincide with the launch of the Pain Free Hospital Initiative (PFHI), an initiative funded by the American Cancer Society. The PFHI is a one-year hospital-wide quality improvement initiative to integrate pain treatment into service delivery as a low-cost intervention designed to demonstrate effectiveness and create local champions for pain relief. 

Launching the policy and the PFHI on World Hospice and Palliative Care Day, the Assistant Minister of Health, Hon. Dikgang Philip Makgalemele, noted that achieving a pain free environment for patients was a process that had to start from somewhere to ensure palliative care is provided within all settings. The role of the Ministry of Health and community leadership was seen as indispensable. Dr Makgalemele stated that the policy would strengthen palliative care referrals across the continuum of care. 

Dr Miriam Sebego, representing the Botswana Hospice Palliative Care Association (BHPCA), highlighted the association’s role to act as a coordinating body for resources and information, advocating for appropriate palliative care services and advocating for medicines availability. The association was launched in July 2014 with support from the African Palliative Care Association and the HIV/AIDS Twinning Center through the American International Health Alliance. 

Despite being a Sunday, the event was attended by more than 200 guests and dignitaries. Other key guests included:

• The  World Health Oranozation (WHO) representatives in Botswana, Dr Martins Ovberedjo and Dr Tebogo Madidimalo
• The Ghanzi area MP, Hon Noah Serikgweri Salakae
• Ministry of Health officials including Mrs Penny Makuruesta and Dr Bornapate Nkomo
• The Ghanzi District Health management Team
• National and Community NGOsC
• Civil society organizations like hospices
• Palliative care beneficiaries and survivors
•  African palliative Care Association and the Botswana Hospice and Palliative Care Association.

The celebrations started with a 20 Km walk creating awareness ending at the Ghanzi bus rank. Speeches were given by various invited guests before the guest of honor officially launching the Policy and the Pain Free Hospital Initiative. Key messages included the need for everyone to be involved and have a role in implementing the policy to ‘relieve the pain and suffering of others and oneself’ through practicing health behaviors like early screening for early detection of illnesses and adopting healthy lifestyles like drinking water (there were incidences of people dying from heat strokes due to the high temperatures from some parts of the country).

The role of the community was highlighted by all, especially the area MP who pointed out that the people needed to walk the talk in the community. 

As much as there was need for education and community mobilization and presence, he noted that the community had the most important virtue – love, which would achieve much. The WHO representative (Dr Martins),  promised support to the country on making accessible medications, guidance on services, and sharing best practices on PC delivery models. APCA congratulated the government for launching the policy as it was a key step towards meeting the May 2014 World Health Assembly resolution for palliative care.

The participants were urged not to let the policy be shelved but implemented. The take home question was: Are you taking part in implementing the policy? You have a role.