Palliative Care Association of Uganda seeks more funding

The Palliative Care Association of Uganda (PCAU) has asked government to allocate a budget for palliative care services to move from health facilities to communities and homes.

Mark Donald Mwesiga, the Executive Director of PCAU, said the association is advocating for every health centre IIIs, IVs and general hospitals to be given money for health workers to go and care for bedridden patients in communities and homes.

“We want to see the government deliberately put a budget for palliative care services to move from health facilities to communities and homes,” he said.

Mwesiga said the health care system especially in public health facilities is designed in a way that people go to health facilities when sick and the health workers do not find them at home and in the community. In this regard, there is a need for government to invest in taking services to the community.

Mark Donald Mwesiga, the ED Palliative Care Association of Ugnada addressing journalists during the commemoration. (Photo by Agnes Kyotalengerire)

“We need a team of dedicated health workers from national referral, regional referral, general hospitals and health centre IV to go to the communities as opposed to the structure system where patients go to health facilities to seek medical care,” Mwesiga said.

He noted that such a strategy will enable bedridden patients to have their medicine delivered but also get a professional health worker attending to them.

Globally with Uganda inclusive, resources for palliative care have been minimal. As such, palliative care has survived broadly on charity, donations and contributions which makes it difficult for the association to implement the home care program, he said.

Although the government of Uganda is paying for access to the oral liquid morphine, Mwesiga said the other medicines that accompany morphine are not paid for.

He made the remarks during the national commemoration of World Hospice and Palliative Care Day under the theme: “Compassionate communities together for palliative Care” at Taibah International School along Entebbe Road on Saturday.

For the 2018/2019 financial year, the Palliative Care Association of Uganda proposed that government increase the budget allocation for palliative care.

They did a calculation that was costing the national palliative care policy implementation. They established that the country would be required to improve the resources located to palliative care by sh2.5 billion. As such, this would increase by 7% over the subsequent years. Four years down the road, the allocations to the health sector are missing that very important component ensuring palliative care is prioritized.

The assistant commissioner of palliative and Hospice at the Ministry of Health, Dr. Moses Muwanga has advised the association to work through the local government structures to access funding.

Dr Muwanga admitted that the budget allocation is not enough but they are working around the clock to ensure the money for this service is increased.

The purpose of palliative care is to provide relief from pain and other distressing symptoms, affirm life and regard dying as a normal process, integrate the physiological and spiritual aspects in patient care, and offer a support system to help patients live actively until death. 

Palliative care services will be required by everybody at a given point in life, so there is a need to have them integrated into the health care system. Specifically, there is a need to be concerned because the life expectancy in Uganda has improved and as people live longer they are susceptible to life-limiting illnesses including some infectious diseases, Mwesiga said.

He noted that we also need to care because our healthcare system will not be complete if it leaves out palliative care services. We need to care because there is pain, and suffering in the community.

Palliative care starts from the point of diagnosis but is emphasised at the point of death or at end-of-life care which all of us will experience in life, he said

Background

October 14, is commemorated as the World Hospice and Palliative Care Day.

Palliative care is an approach that improves the quality of life of patients and their families with life-threatening illnesses, through the prevention and relief of suffering, using early identification and impeccable assessment and treatment of pain and other problems, physical, psychological social and spiritual.

Palliative care was first introduced to Uganda in 1993 with the start of Hospice Uganda (HU). Palliative care services are found in over ninety districts of Uganda and only in accredited health facilities. These include the national referral hospital, regional referral hospitals, district hospitals, general hospitals and some health centre IVs.

There are also free-standing palliative care programs or hospices located throughout the country which provide different models of palliative care, including home care, roadside community daycare, as well as facility-based daycare.

For example, Hospice Africa Uganda, Mildmay Uganda, Reachout Mbuya, Kawempe Home Care, Mobile Hospice Mbarara, Little Hospice Hoima, Rays of Hope Hospice Jinja, Joy Hospice, Home Hospice at Clare, Hospice Ngora, Kagando Home Care Program, Little Hospice, Hospice Tororo, New Life Hospice, New life and Peace Hospice.