Preparedness of African palliative care services to respond to the COVID-19 pandemic: A rapid assessment

Boufkhed, Sabah; Namisango, Eve; Luyirika, Emmanuel; Sleeman, Katherine E.; Costantini, Massimo; Peruselli, Carlo; Normand, Charles; Higginson, Irene J.; Harding, Richard

CONTEXT: Palliative care is an essential component of the COVID-19 pandemic response, but is overlooked in national and international preparedness plans. The preparedness and capacity of African palliative care services to respond to COVID-19 is unknown. OBJECTIVE: To evaluate the preparedness and capacity of African palliative care services to respond to the COVID-19 pandemic. METHODS: We developed, piloted and conducted a cross-sectional online survey guided by the 2005 International Health Regulations. It was emailed to the 166 African Palliative Care Association's members and partners. Descriptive analyses were conducted. RESULTS: Eighty-three participants from 21 countries completed the survey. Most services had at least one procedure for the case management of COVID-19 or another infectious disease (63%). Respondents reported concerns over accessing running water, soap and disinfectant products (43%, 42%, and 59% respectively), and security concerns for themselves or their staff (52%). Two in five services (41%) did not have any or make available additional Personal Protective Equipment. Most services (80%) reported having the capacity to use technology instead of face-to-face appointment, and half (52%) reported having palliative care protocols for symptom management and psychological support that could be shared with non-specialist staff in other healthcare settings. CONCLUSION: Our survey suggests that African palliative care services could support the wider health system’s response to the COVID-19 pandemic with greater resources such as basic infection control materials. It identified specific and systemic weaknesses impeding their preparedness to respond to outbreaks. The findings call for urgent measures to ensure staff and patient safety.