Spiritual Care Recommendations for People Receiving Palliative Care in sub-Saharan Africa

by David Galimaka; Irene J. Higginson; Keletso Mmoledi; Lucy Selman; Peter Fox; Richard Harding

Sep 15, 2010
These recommendations aim to inform the provision of spiritual care for people receiving palliative care in sub-Saharan Africaby providing evidence-based guidance for palliative care service providers. The recommendations are designed to be broad and adaptable to different local conditions, so that they are applicable across sub-Saharan Africa, and to complement and facilitate the attainment of the APCA standard on spiritual care.
  • In 2008, 22.4M people were living with HIV in sub-Saharan Africa, 67% of the global total of those affected. In the same year, an estimated 1.9M adults and children became infected with HIV, and 1.4M adults and children died of AIDS.
  • While access to ART is crucial to prolong life, patients on ART continue to experience pain and other chronic symptoms caused by the underlying disease progression, co-morbidities and opportunistic infections, as well as the significant psychosocial and spiritual problems related to living with the diagnosis.
  • In addition to the burden of HIV, cancer and other non-communicable diseases are becoming urgent public health issues in Africa, with one in five deaths in sub-Saharan Africa due to cancer; in females, the lifetime risk of dying from cancer in Africa is almost double the risk in developed countries.
  • The number of people in Africa over 60 years old is projected to quadruple by 2050, with the lifetime risk of cancer expected to increase by 50-60%, and the annual number of cases to rise from 650, 000 to 2.2 million.
  • According to WHO estimates, approximately 8.2 million people are currently in need of palliative care in sub-Saharan Africa.
  • The African Palliative Care Association (APCA) has made a significant contribution in developing standards and core competencies for palliative care which include spiritual care, recognising that spirituality and religion often play a key role in the experience of serious illness. There is evidence that spirituality is an important coping resource in sub-Saharan populations, and that patients experience spiritual distress.
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