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The state of play

A critical unmet need for end-of-life care in Ghana and across Sub-Saharan Africa

Mother and Son Walking Down Street

In low-resource communities in Ghana, the lack of palliative care means that patients with life-limiting illnesses are too often left to die an isolated, painful and undignified death.

“The desire to care for dying loved ones is universal but access to palliative and end-of-life care in Ghana is not.” – Dr Cecilia Akrisie Anim CBE, FRSA, FRCN

“Many families can face loss of income, disruption to education and personal anguish and anxiety, directly trapping them and future generations into cycles of poverty.” – Mr Ernest Ahiaku MB, FRCS,FGCPS, DL

What does it mean?

In low-resource communities, this lack of palliative care services is not only devastating for the dying, but for the community too. The physical and mental demands of care can result in loss of income, and disruption to family life and business, disruption or termination to the children’s education, not to mention personal uncertainty, anguish and anxiety within the home and in the wider community.

These losses directly trap individuals, families and future generations into poverty cycles with devastating outcomes.” – The Reverend Monsignor Alex Bobby Benson, Diocese of Koforidua

The problem

Fragmentation, dislocation and under-funding characterise the current landscape for end of life care in Ghana, despite the country’s status as a continental leader in health insurance and strong government and societal support for health system development. Against this backdrop, small investments in end-of-life care can prove transformational.
The reality in Ghana looks like this:

  • Acute shortage of specialised palliative care staff – who finance their own training.
  • A brain drain as trained staff are pulled overseas attracted by better terms and conditions of service.
  • Inadequate training capacity and a lack of a national palliative care policy.
  • Poor infrastructure and weak coordination between services.
  • Family caregivers and families usually provide home-based palliative and end-of-life care unsupported by health staff due to poor resource and geography.
  • No patient pathway or choice of treatment, the patient comes last.
  • Palliative referrals are too late, poorly planned and traumatic.
  • No dedicated in-patient palliative ward in any of Ghana’s leading teaching institutes for children or adults.
  • Opioid pain relief is often out of stock, difficult to access or prohibitively costly.
  • Care and the dignity of care depend on the family and their knowledge.
  • Too many die alone, in distress and without dignity – yet their courage and resolve shine through.
  • Lack of provision for, or costing of, the delivery model for end-of-life care.
  • Lack of strategic plan at the national/regional level for palliative and end-of-life care.
  • Absence of meaningful public and demographic Health Data to guide decision-making and resource allocation.
  • Poor integration across services.
  • Collaboration is seen as a weakness, not a strength.

Our Work

Our mission is to tackle these problems head on in partnership with trusted local stakeholders, to improve the quality of life for patients and families in Ghana and beyond. We intend to achieve this by providing world class expertise, capability and resources to enable communities to harness these skills to provide quality palliative and end of life care in a sustainable way.

Using a three pronged approach, we educate, embed and collaborate to instil leading standards of palliative care into Ghana for positive systematic change.

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