A majority of health facilities accredited to
provide palliative care in Uganda are failing to live to the required
Palliative Care Association of Uganda Chairperson, Mark
Donald Mwesiga says 77 out 226 health facilities can ably provide the care
needed by patients in critical pain.
///Cue in:” We have done ……….
Cue out: ………… they are transferred”. //
care is an approach that improves the quality of life of patients (adults and
children) and their families who are facing problems associated with a life-threatening
prevents and relieves suffering through the early identification, correct
assessment, and treatment of pain and other problems, whether physical,
psychosocial, or spiritual.
accredited facilities are supposed to provide six types of services: outreach, home
visits, psychosocial, legal, bereavement, and spiritual support, but only for
an average of 7 months a year due to lack of facilitation and transportation.
Palliative care is
required for a wide range of diseases. The majority of adults in need of
palliative care have chronic diseases such as cardiovascular diseases (, cancer,
chronic respiratory diseases, AIDS, and diabetes.
Many other conditions
may require palliative care, including kidney failure, chronic liver disease, and
multiple sclerosis among others.
A recent study in Uganda
found that more than a third of the patients were diagnosed with
non-communicable diseases, highlighting their significance alongside cancer and
HIV/AIDS as conditions requiring palliative care.
and other Ugandan researchers in April this year published findings from the quantitative
descriptive study of key palliative care indicators 2018-2020.
study whose findings have been published in BMC Palliative Care journal provides
an overview of the availability of palliative care services in the country and
the challenges and gaps in Uganda prior to the global COVID-19 pandemic.
to the study, there
were 226 accredited palliative care facilities across Uganda’s 135 districts in
districts lacked any accredited palliative care facility. The study found that almost a third of the districts in Elgon, a sub-region in Eastern Uganda, had no palliative care facilities.
Districts with the most palliative care services were Kampala , Wakiso, Tororo , Jinja, Kabarole, Masaka, Mbarara, Ntungamo and Rukungiri each had five accredited facilities.
It found that the
majority (68.1%) of accredited facilities were public, and private facilities
received slightly more pain-relieving morphine.
The Ministry of Health is supposed to accredit
facilities that offer oral liquid morphine, a drug that Uganda innovated to
manage pain in patients.
Morphine is however a restricted drug due to the
risk of abuse, and addiction. It can also cause fatal breathing problems if not
Palliative care Service providers have in the past complained
about the restrictions and rigorous process of ordering morphine from National
Medical Stores and Joint Medical Stores.
The Director of Clinical Health Services, Dr. Charles Olaro told URN in an interview that the stocking of facilities
is based on what they demand.
///Cue in:” You know oral ………..
Cue out: …………..to the facility". //
He however acknowledges that the palliative care
service coverage is not equitable as some areas have a big concentration of
health facilities accredited than others.
Olaro said that the ministry will soon start alignment
access to ensure access for all.
///Cue in:” We need this ………..
Cue out: ……….. aspects of control”. //
The World Health Organisation has issued guidelines for countries to follow to
put in place an essential palliative care package but Uganda still doesn’t have
a guiding national policy despite starting this process over ten years ago.
The lack of policy according to Mwesiga affects how quickly access can be
enabled everywhere in the country.