Raphael Ede
Stakeholders drawn from different spheres of sector have canvassed quality care for Nigerians living with chronic diseases, especially women with HIV and cervical cancer.
In a gathering in Enugu, they brainstormed on possible ways to co-create and develop a feasible, culturally adapted, and sustainable palliative care service package in communities for patients with chronic illnesses.
The participants were drawn from community leaders, faith-based leaders, community health workers, doctors, pharmacists, traditional healers, nurses, market women leaders, and patients living with HIV, among others.
The Executive Director of the African Palliative Care Association, Dr Emmanuel Luyirika, while speaking, explained that the project PACE-2 Study was aimed at utilizing well-established mixed-method approaches to adapt core elements of palliative care services recommended in the National Comprehensive Cancer Network.
He revealed that NCCN had developed clinical practice guidelines for sub-Saharan Africa that promote access to quality, evidence-based palliative care.
Luyirika noted that the workshop was meant to find feasible and acceptable culturally adapted and integrated palliative care services to promote the well-being of women living with HIV and cervical cancer.
A Medical Sociologist and Senior Investigator at the IVAN Research Institute, Dr Ngozi Idemili-Aronu, revealed that cervical cancer is the fourth most common cancer in the world and the second most common cancer among Nigerian women.
She said “The risk of CC is six times greater in women living with HIV compared to non-HIV-infected women, with an estimated 5 percent of CC linked directly to HIV infection. Early detection, treatment, and provision of palliative care services have been shown to improve outcomes and enhance chances of survival. Improvement in clinician’s knowledge, skills, and confidence in providing appropriate PC results in improved patient satisfaction with clinical care.”
Idemili-Aronu, who is also a senior lecturer at the University of Nigeria, Nsukka, explained that the PACE-2 Study is a one-year – September 2023–September 2024 – supplement to the five-year National Institutes of Health sponsored grant-Accelerating Cervical Cancer Elimination through the Integration of Screen-and-Treat Services.
She lamented that despite the adoption of NCCN guidelines in Nigeria, PC services remain underdeveloped and inaccessible at most healthcare facilities, including where the parent study is being implemented.
On the approach and study aims, she explained that the PACE-2 Study is being implemented across the six geopolitical zones in Nigeria and will leverage the ICON-3 Practice-Based Research Networks of the Nigeria Implementation Science Alliance.
Idemili-Aronu, further explained that the training workshop was all about trying to co-create a community palliative package with people living with chronic illness in our communities.
She added, “We are trying to do this package for communities because people living with chronic illnesses are in our communities and have no access to palliative care services. Palliative care services are basically, based in Tertiary Institutions and usually far away from the people that need these services.
“So these people live in places where they have only primary healthcare centres and the closest facilities to them are the secondary facilities – general hospitals. So we are trying to co-create a context-specific package that can be used for people living in these communities and these communities where there are no palliative care experts.”
“We are getting input from the community members and palliative care experts in their midst to guide the process, religious leaders, CHUS, nurses, traditional medical practitioners, support group leaders, adorers counselors – all these people link to the community.
“Even people living with these illnesses are also part of the training workshop – sickle cell, cancer patients, HIV – they are part of us trying to build this package – something that they think can be applied to them in their communities. So that is what we are doing.”
Head of Cancer Control, and Nuclear Medicine Desk, Department of Hospital Services Federal Ministry of Health and Social Welfare, Dr Uchechukwu Emmanuel Nwokwu, while speaking, commended the organisers for the initiative.
He said, “When I was invited I was very curious to understand what it means to co-create a package for palliative care in the communities. It wasn’t very clear to me what they were up to and what they intended to achieve.
“But having been here for these few days I have come to realize that they are doing something very unique, which is very important for us to achieve the provision of palliative care services in our health sector.
“If I may add, I was instrumental in the development of the first palliative care policy in Nigeria which the Ministry of Health launched in 2021. That document provided for the provision of palliative care services at all levels of healthcare – from the primary level to secondary to tertiary levels of care. So, what IVAN Institute is doing is very unique if we must integrate palliative care services into our healthcare, especially at the community levels, where primary healthcare exists.”
He explained that most of the services in the country on palliative care are obtained only at the tertiary levels of care.
“But co-creating the package for the community experts is something that is going to be very useful at the primary levels of care and secondary levels of care. So I am quite happy about participating in this and is going to also influence what we are going to do in reviewing the national palliative care policy which is due for mid-term review later this year.
“When we review it I am going to use what I have learned here and what the participants in this programme have been able to co-create to have a second look into that our national policy as it is going to influence. I am impressed with what I have seen so far and we are going to take it from here to ensure that Nigeria taps from the experience of all these experts and all the participants in this training, “he added.
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