HIV Care The Diana, Princess of
Wales Memorial Fund The Fund continues the Princess' humanitarian work in the UK and overseas. By giving grants to organisations, championing charitable causes, advocacy,
campaigning and awareness raising, the Fund works to secure sustainable improvements in the lives of the most disadvan- taged people in the UK and around the world. The Palliative Care Initiative’s aim is for palliative care in sub-Saharan Africa to be integrated into the care and treatment of people with HIV/AIDS, cancer and other life-limiting illnesses.
For more information please contact: The Palliative Care Initiative The Diana, Princess of Wales Memorial Fund: The County Hall, Westminster Bridge Road, London SE1 7PB, UK Tel: +44 (0) 20 7902 5504 Fax: +44 (0) 20 7902 5511 Email:
sally.lyon@
memfund.org.uk www.theworkcontinues.org
FHI360 is a non-profit human develop- ment organisation dedicated to improv- ing lives in lasting ways by advancing integrated, locally driven solutions. Our staff includes experts in education, health,
nutrition, economic development, civil society, environment, gender, youth, research, and technology – creating a unique mix of capabilities to address today's interrelated development challenges. FHI360 serves more than 60 countries and all US states and territories. For more information please contact FHI360, 1825 Connecticut Avenue NW, Washington, DC 20009 USA Tel: 1.202.884.8000 Fax: 1.202.884.8400
The African Palliative Care
Association Central to the work of the African Pallia- tive Care Association (APCA) are patients, their families, and carers. They, and the millions of people who need palliative care but who are not fortunate enough to receive it, are behind everything APCA
does. It is the regional voice for palliative care, speaking for the whole of Africa and has a strategic vision to ensure access to palliative care for all in Africa. In the past, less than effective health delivery systems have posed a substantial challenge to APCA’s attempt to realise this vision. According to the World Health Organization there are six fundamental building blocks of a generic health system. A critical component of WHO’s ser- vice delivery building block is a package of integrated services. However, despite being defined as an essential component of a comprehensive package of care for people living with life-limiting illnesses, palliative care is a variable component of service delivery models in Africa. A health system that excludes palliative care services is deficient and not working optimally. Strengthening health systems to ensure the public health delivery of palliative care therefore underpins APCA’s strategic direction.
For more information and copies of this report please contact: The African Palliative Care Association PO Box 72518, Kampala, Uganda Tel: +256 414 266251 Fax: +256 414 266217 Email:
info@africanpalliativecare.org www.africanpalliativecare.org
Front cover © Nadia Bettega 18 Africa Health July 2012
Contents This Special Report has been prepared by The
Palliative Care Initiative of The Diana, Princess of Wales Memorial Fund, FHI360, The African Palliative Care Assciation, and SafAIDS
Where’s the care in the post-
ART era? Enhancing adherence, retention, and quality of life in people living with HIV through integrative approaches. Kimberly Green, Olivia Dix, Faith Mwangi-Powell, Carla Horne, and Emmanuel Luyirika discuss
How HIV care promotes prevention
Theo Smart looks at HIV care and support services which are well placed to promote Positive Health, Dignity, and Prevention (PHDP)
Care and support during the pre-ART stage: what is the
role of palliative care? Michelle Meiring reflects on ways palliative care can support pre-ART service delivery
Integration: making it happen
Olivia Dix, Kimberly Green, and Carla Horne discuss five key steps HIV clinicians and programme managers can take to integrate palliative care into HIV services
Children and HIV care needs
Understanding the range of symptoms experienced by children living with HIV is vital in designing quality care services. Veronica Tembo, Faith Mwangi-Powell, and Jane Nakawesi assess best practice options
Research on the impact of palliative care services offered
in ART clinics Richard Harding describes the ‘TOPCare’ randomised controlled trials in two sub-Saharan African countries
If you are reading this publication on its own, it is a reprint from the July issue of Africa Health journal (Volume 34 number 5).
www.africa-health.com
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