The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 19: Palliative Care in Resource-Poor SettingsTable 19-2: Palliative Care Component of theUganda National Health Sector Strategic Plan26 picasVerifiable Means of Activities at theOutput Indicators Verification the Operational LevelAccessibility ofpalliative carefor chronicallyand terminallyill personsincreased1. Proportion ofpatientsreceivingpalliative care2. Number ofhealthproviderstrained inpalliative care1. Field visits,feedback fromcommunities,district andhealth facilityreports2. Training reports,performanceappraisal reports1. Carry out training of healthproviders on palliative care2. Provide supplies for palliativecare at all levels of healthcare3. Integrate palliative care into thecurricula of training institutions4. Provide technical backup to thedistrictsSource: Reprinted with permission from Ministry of Health, Republic of Uganda. National Sector Strategic Plan 2000/01 – 2004/05.care with care for the dying and care for caregivers. All 10 care areas have concurrent professionaleducational programs. Each team has developed a unique approach to meet regionalneeds, working to integrate a comprehensive AIDS care program into every level of the healthcaresystem, including communities and families (Available at www.eci.harvard.edu). 50WHO: A Community Health Approach to Palliative Care for HIVand Cancer Patients in Five African CountriesWHO is developing a Community Health Approach to Palliative Care for HIV and CancerPatients in five African countries (See Table 19-3 for prevalency rates in participating countries).51 The program is unique in combining policy advocacy for both AIDS and cancer patientswithin a national healthcare program. Each participating country is asked to develop and integratepalliative care initiatives into their national health policies. The program’s long-term goalsare to foster national policies in palliative care, provide public and professional education onTable 19-3:Countries Involved in the WHO Community Health Approachto Palliative Care for HIV and Cancer Patients in AfricaLife ExectancyCountry Population at Birth Cancer HIV/AIDS in 1999AdultMillions (years) 1999 Incidence Mortality prevalence People Death2000 rate % living withEthiopia 62.9 42.4 64,657 39,920 10.63 3,000,000 280,000Tanzania 35.1 45.0 33,409 21,002 8.09 1,300,000 140,000Uganda 23.3 42.1 17,058 10,504 8.30 820,000 110,000Zimbabwe 12.6 40.4 13,030 8,648 25.06 1,500,000 160,000Botswana 1.5 39.4 1,168 810 35.8 290,000 24,000Source: World Health Organization. A Community Health Approach to Palliative Care for HIV and Cancer Patients in Africa. WorkingDocument, November 2001.402U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau