In Mozambique, palliative care is still quite a new concept. There have been a number of challenges in developing a national palliative care policy, including the fact that it still has not been fully integrated into existing national health policies.
Until this happens, the public cannot enjoy their right to adequate palliative care services.
However, there has been some progress. Last year the Ministry of Health (MoH) approved the palliative care policy. From the very start, MOPCA has been working closely with the MoH to ensure steps have been taken to implement this policy. In addition, the Mozambique Palliative Care Association (MOPCA) has worked closely with the Ministry of Health (MoH) to design standards that include palliative care provision.
MOPCA continues to work with the MoH to ensure that the policy will be implemented through home based care with other national stakeholders and palliative care providers working together.
However, many barriers still exist that prevent everybody in Mozambique from enjoying equal access to effective palliative care services. For example, access to effective pain medication is often not adequately available to patients in need.
Other barriers identified include:
- Excessively strict national laws and regulations
- Fear of addiction, tolerance, and side effects
- Poorly developed health care systems and supply, and
- Lack of knowledge on the part of health care professionals, the public, and policy makers.
Opioid availability and pain management is currently only addressed in the pain unit sector. MOPCA is working however to ensure that this conversation will expand over time to include other services.
MOPCA and the MoH have held many meetings and have agreed to:
- Give presentations to all health units within the MoH to motivate staff
- Prepare minimum levels of training in palliative care that can be incorporated into existing training packages for health care professionals
- Organise workshops in major hospitals.
In addition, a working group has been created with representatives from the MoH, MOPCA, and other healthcare partners.
These initiatives will not only raise awareness but to also incorporate contributions from health workers on the ground.
The training modules for trainers and volunteers of home based care are also being reviewed. This review aims to look at how to integrate palliative care into the training of those who are already working in the community. MOPCA still needs to provide support to trainers to ensure the quality of training is kept high.