• J Pain Symptom Manage · Apr 2018

    Palliative Care Need and Availability in Four Referral Hospitals in Senegal: Results from a Multicomponent Assessment.

    • Hana Hamdi, Oumar Ba, Serigne Niang, Christian Ntizimira, Mouhadou Mbengue, Aminata Sophie Coulbary, Rokhaya Niang, Matthew Parsons, Joseph J Amon, and Diederik Lohman.
    • Columbia University Mailman School of Public Health, New York, New York, USA.
    • J Pain Symptom Manage. 2018 Apr 1; 55 (4): 1122-1130.

    ContextWith prevalence of noncommunicable diseases and life expectancy rising in Senegal, the need for palliative care is likely growing. No national palliative care needs assessments have been carried out.ObjectivesTo assess the capacity and need for palliative care in Senegal.MethodsA multicomponent assessment of availability and demand for palliative care was conducted in two tertiary and two regional hospitals in Senegal in 2015 with approval from Senegal's National Ethics Committee for Health Research. The assessment consisted of (1) an inpatient hospital census; (2, 3) surveys of inpatients and outpatients with life-limiting illness; (4) a knowledge, attitudes, and practices survey among health care workers; and (5) a facility survey to assess availability of palliative care medications.ResultsNearly half (44.4%) of all inpatients (n = 167) had an active life-limiting illness. Among them, 56.6% reported moderate-to-severe pain in the past three days, 2.3% of whom received morphine, and 76.7% received weak or no pain medication. Inpatients also experienced moderate-to-severe dyspnea (42.1%), fatigue (66.5%), nausea (16.5%), and drowsiness (42.1%). About 39.2% of all outpatients (n = 395) reported moderate-to-severe pain, and 52.8% reported that the treatment they had received relieved their pain only partially or not at all. Two-thirds of all doctors reported feeling comfortable prescribing pain medicines; however, 83.0% rarely or never prescribed morphine. Two of four hospitals reported no use of morphine in 2014.ConclusionThere is significant need for palliative care in Senegal. Training of health care workers and ensuring availability of relevant medications should be prioritized.Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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