• Oladayo A Afolabi, Kennedy Nkhoma, Olaitan Soyannwo, Akinyemi Aje, Adesola Ogunniyi, Richard Harding, and Matthew Maddocks.
• Cicely Saunders Institute of Palliative care (O.A.A, K.N., R.H., M.M.), Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative care, King's College London, London, UK; Department of Nursing Science (O.A.A.), University of Maiduguri, Maiduguri, Nigeria. Electronic address: oladayo.afolabi@kcl.ac.uk.
• J Pain Symptom Manage. 2022 Oct 1; 64 (4): 319-329.

BackgroundPalliative care should be integrated into primary healthcare systems within low- and middle-income countries to achieve Universal Health Coverage goals. We aimed to identify preferences and expectations for primary palliative care among people living with serious illness and their families and the readiness of primary healthcare providers to deliver primary palliative care in Nigeria.MethodsQualitative descriptive interview study with 48 participants: people living with serious illness (n=21) and their family caregivers (n=15), healthcare providers (n=12). Data were analysed using thematic analysis.ResultsThree major themes were identified. 1.) Engaging patients and families. 2.) Managing patients and families' expectations and preferences. 3.) Addressing staffing-related issues. Patients and families have existing trust and bonds from using primary healthcare but lack individual agency necessary for person-centered care decisions. They expect an easily accessible service, opportunities for social interaction and adequate communication. Development of healthcare providers is needed to ensure an appropriate clinical response, manage interprofessional trust and ensure clear role delineation.ConclusionsOur findings have identified specific approaches to implement the WHO policy on integrated primary palliative care. Palliative care integration within primary healthcare in Nigeria can be achieved through building information and communication skills of healthcare providers, engaging and empowering patients to exercise their agency in care decisions, and adequately delineating healthcare providers' roles to ensure staff work within their competencies and training.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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