Palliative care for older people - World Health Organization ...

15Improving palliative care in resource-constrained settings“Palliative care is an urgent humanitarian needworldwide.”Source: Palliative care (1).There is unanimous agreement that good palliativecare should reach everyone who needs it. Althoughproviding examples of palliative care for older peoplein resource-constrained settings such as Africa isbeyond the scope of this publication, includingsome reference to these settings is important fortwo main reasons.First, these countries greatly need better palliativecare. Second, the European Region can learn fromsome of the developments in resource-constrainedsettings, where much is achieved in the communityon low budgets such as mobile hospices in Uganda(shown in photograph). Bus rounds could be atime-saving and cost-effective way of providingeducation in palliative care (Box 15.1).Palliative care is an emerging discipline in Africa.Although there are centres of excellence providingholistic palliative care and education, these tendto be few and cannot currently provide enoughpalliative care to appropriately respond to the HIVepidemic, to progressive malignant disease andto the yet-unknown burden of non-malignant,non-HIV-related deaths. Research and auditing areessential to capture the lessons learned, to guidethe wise allocation of scarce resources, to developfeasible and acceptable local models of palliativecare and to ensure that people needing care andfamilies in resource-constrained settings receiveeffective care. The example shown in Box 15.2demonstrates the importance and feasibility oflocally owned measurement and improvement ofquality for people with progressive and advanceddisease and their families in resource-constrainedsettings.© Anne Merriman46