Palliative Care Strategy for HIV and other diseases - FHI 360

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resources (food, clothes, money) for patients in need and OVC, and they contribute to
addressing the pressing needs of PLHIV including shelter. Most idirs are becoming more
visionary, showing strategic thinking toward sustainable ways to address community problems
such as OVC.
The existence of dedicated CHBC caregivers in the program has tremendously improved
community attitudes. There is an appreciation for what the caregivers are doing, as opposed
to the resistance at the start of the program. Most caregivers are proud of what
they are contributing and have developed a feeling of responsibility for their patients. In
general, there is positive change toward voluntarism, and the caregivers are seeing that
participation in service provision has a positive impact on their own lives, because they
acquire knowledge and skills through their engagement. The involvement of caregivers has
positively increased neighborhood support for visiting and supporting patients; many have
started to supply food and are helping with household chores.
vietnam: development oF national palliative Care program
In 2005 a team of PEPFAR partners* responded to a request from the Ministry of Health
Therapy Department to develop national palliative care guidelines—standards that would
form the basis for a national palliative care program for the estimated 300,000 PLHIV and
approximately 200,000 people diag-
The 2005 Ministry of Health Palliative Care
Needs Assessment found that
• 75 percent of PLHIV and people with
cancer reported pain
• 5 percent of healthcare workers reported
availability of oral morphine in
their healthcare setting
• 76 percent of healthcare workers were
unable to identify correct pain management
strategies
• 85 percent of policymakers recognized
that measures to address pain
and other symptoms were inadequate
in Vietnam
nosed with cancer each year.
The first step was to assess palliative
care needs among people with HIV/
AIDS and cancer. The assessment
included 451 people with HIV/AIDS
and cancer, their caregivers, healthcare
policymakers, and healthcare
providers in five high-HIV and cancer
provinces. Results from the assessment
were compelling (see box)
and provided a foundation for the development
of national palliative care
guidelines in 2006.
PEPFAR partners provided significant
support to a technical working
group led by the Ministry of Health
Therapy Department in creating the
guidelines. Drafts were presented to a body of experts who provided feedback and comments,
and the final version was approved by the Ministry of Health Scientific Committee
in September 2006. They are comprehensive and include all elements of palliative care as
outlined in this paper: palliative care principles, management of pain and other symptoms,
psychosocial needs and support, spiritual support, end-of-life care, and care for caregivers.
* FHI/Vietnam, Vietnam-CDC-Harvard Medical School AIDS Partnership (VCHAP), and the Health Policy
Initiative.