Taking Palliative Care to the Community Level

Categories: Community Engagement.

Statistics show that only 10% of those who require palliative care services can access them and this needs to be remedied hence the need for training of more health care workers across more facilities. The target is more public healthcare workers from sub-county hospitals. Other targets are opinion leaders, religious groups, community groups, schools, youth and county stakeholders.

The idea is to use the following avenues to reach more patients and health care workers:-

Ø  Community sensitization

Ø  Media engagement

Ø  Training of health care workers

Ø  Strengthening hospitals to undertake monitoring and evaluation

Ø  Strengthening the integration of palliative care

Ø  Mentorship

The main target group, community health workers, volunteers and support groups will be reached through three day workshops with 20 participants per site being targeted for training. The aim is to strengthen referral linkages and follow up of patients after discharge. Nyeri County hospital has had a successful program whereby trained health care workers and volunteers have gone on to refer many patients to the hospital and Nyeri Hospice for treatment. “Since we started training of community health care workers and volunteers, they have become more active in day care and in spreading palliative care news among the community,” said Lydia Warui from Nyeri County Hospital.

Strengthening of paediatric palliative care was also identified as a key component of phase three citing the fact that very few children are accessing services and treatment. Paediatricians and health care workers will be the target in this aspect with a half day workshop in each of the 11 sites.

Engagement of local media stakeholders is another aspect of the project aimed at using this powerful tool to sensitize the public on palliative care matters. Radio talk shows have been identified as the best platform to use as almost every household in Kenya has one and radio can now be accessed through mobile phones. The aim here is to strengthen referral networks, community awareness and disperse accurate information and dispel myths. The representatives of the palliative care units in Machakos and Embu told of their successful interaction with the public and media after the former was hosted on a popular vernacular radio station and the latter held a familiarization media breakfast meeting with the media in Embu County.

The Embu team is in the process of helping media in the region highlighting a needy family that needs basic support and palliative care for three of their children. The Nyeri County team has a weekly one hour spot at their local radio station, Rware FM, where every Friday between 10 and 11Am they are afforded time to speak on matters healthcare to the audience. The Coast team spoke of their great partnership with media in the area who they regularly sensitize on matters palliative care and the media partners in turn raise awareness among the public.

Strengthening of monitoring and evaluation has also been identified for the 11 sites and will be done by way of a joint training targeting staff in all hospitals.

Mentorship for sub-county hospitals and other health care facilities in counties is targeted through the 11 hospitals identifying two lower level facilities that are interested in integration or are in the process of integrating palliative care. Thika hospital is interested in mentoring Murang’a hospital; Machakos interested in mentoring Kitui; and Garissa hospital wants to target sub-county hospitals and dispensaries.

Dr. Asaph Kinyanjui, KEHPCA Director of Programs, said of the initiative, “KEHPCA will support your hospitals and these sites to conduct mentorship visits. You as heads will need to cite reasons why these sites deserve to get the said mentorship and also state some of the immediate needs.”

The 11 heads and their representatives suggested that KEHPCA should get in touch with their respective County health departments to ease the process of palliative care integration in county facilities.

The project to integrate palliative care into public hospitals across the county started towards the end of 2010 when the Ministry of Health requested KEHPCA to work with 11 level 5 hospitals to integrate palliative care services. The True Colors Trust and Diana Princess of Wales Memorial Fund supported KEHPCA to undertake the integration between 2011 and 2012. This focused on basic introductory training in palliative care, setting up palliative care units and advocating to the hospital administrators.

The support was to achieve the following:-

Ø  Creating centres of excellence (June 2013- June 2015). This involved training the palliative care providers to become trainers; provide mentorship; provide paediatric palliative care and act as clinical placement centres.

Ø  Integration of palliative care in the community (July 2015- June 2016).

For more information on about the True Colors/KEHPCA project, kindly follow this link:-http://www.truecolourstrust.org.uk/palliative-care-in-africa/waterloo-coalition/

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