Palliative Care Provision in the Kagera Region (PalliCaPro)
Situation:
Only 10% of healthcare facilities in Tanzania provide palliative care. With rising cancer cases, most patients present at advanced stages where symptom management is crucial. Effective symptom control is also vital for poorly managed non-communicable diseases like hypertension, diabetes, and HIV/AIDS but remains largely inaccessible across the country.
Objectives:
The goal of the project is to strengthen and expand palliative care in the Kagera Region, particularly in the Muleba District in northern Tanzania. Led by Ndolage Hospital in close collaboration with the Evangelical Lutheran Church of Tanzania (ELCT), the project focuses on enhancing the training and education of healthcare workers in the region. By integrating physiotherapy, nutrition, and spiritual care, the approach goes beyond purely medical and nursing aspects, reflecting the holistic nature of palliative care. Additionally, the project will standardize the collection and analysis of care data. This data will be used to directly engage and involve local and regional stakeholders, who are essential for ensuring the sustainability of care services.
- Increase of the number of health services and healthcare workers offering Palliative Care
- Improvement of monitoring and evaluation of Palliative Care services
- Raise of awareness and knowledge on Palliative Care among stakeholders
- 4100 patients with cancer, HIV/AIDS or NCDs receive palliative care consultation and, if necessary, treatment
- 20 healthcare professionals attend a specialized palliative care course
- 60 healthcare professionals receive a refresher course in palliative care
- Three community awareness days increase knowledge about palliative care and available services in the region while reducing stigma
- Implementation of electronic data collection
To ensure long-term sustainability, ELCT integrates palliative care into existing programs (e.g., Orphans and Vulnerable Children and Early Childhood Development) and engages local churches to raise awareness through Diakonia desks. Locally, ELCT collaborates with government bodies in the Kagera region to strengthen palliative care advocacy, while nationally, it supports the finalization of the Palliative Care National Guideline.
Financial sustainability is a key focus. The project will explore long-term solutions for retaining healthcare workers, integrating palliative care into standard healthcare services, and reducing out-of-pocket costs. Training other departments at Ndolage Hospital and lower-level facilities will gradually embed palliative care into routine care, utilizing staff beyond PalliCaPro funding.
The most critical step toward financial sustainability is integrating palliative care into the National Health Insurance Fund (NHIF). Adequate data collection and presentation of positive results will be key to apply for integration into NHIF.
Palliative care is still barely or not at all available in many countries. Due to risk factors, population growth, aging population structures, and the associated diseases, the demand for palliative medical care is increasing worldwide.
This is particularly evident in low- and middle-income countries with inadequate insurance coverage, where there is a significant lack of care structures. Targeted support in these regions could help achieve broader implementation.
