UCT prioritises end-of-life care with novel project

As the need for palliative care increases in South Africa, a novel, community-focused initiative is set to completely transform how healthcare workers approach and handle patients and their families in need of critical end-of-life care and support.

Piloted at a primary healthcare facility in Heideveld, by family physician Dr Jennie Morgan, who is based in the University of Cape Town’s (UCT) Department of Family, Community and Emergency Care, the initiative draws on global best practices informed by community-based palliative care models implemented in India and other parts of the world.

The project is funded by VLIR-UOS – a leading funding body for scholarships for and partnerships between academics from Flanders in Belgium and partner institutions in Africa, Latin America and Asia, all of whom focus on global sustainable development. The five-year study responds to the growing need for palliative care in South Africa by developing Compassionate Communities of Care. What’s unique is that it’s anchored in a collaborative, multistakeholder, multi-institutional approach led by UCT’s Chronic Diseases Initiative for Africa (CDIA), the Division of Interdisciplinary Palliative Care Medicine (IPCM) and the Cancer Research Initiative, in partnership with Ghent University and the Vrije Universiteit Brussels, both located in Belgium.

Empowering patients, communities

A fundamental part of the project is capacity building in communities and empowering patients and caregivers with the skills they need to navigate death and bereavement with dignity. Part of the plan is to embed palliative care training into undergraduate and postgraduate medical education, and by doing so, UCT will help to bridge the gap between policy and practice – ensuring that a better trained workforce is equipped to strengthen palliative care delivery in under-resourced settings.

“By strengthening curricular integration of under- and postgraduate students, we will develop educational and capacity building and local agents of change to improve the palliative care landscape in the Western Cape, and South Africa in general,” said IPCM’s Associate Professor Rene Krause.

Limited access

Palliative care is essential for people living with terminal health conditions such as cancer, heart and kidney failure, as well as advanced infectious diseases and dementia. And in South Africa, it’s largely home-based and delivered by hospices – focusing on pain relief and holistic support. However, due to a lack of awareness on death literacy, access remains limited, which often creates fear and reluctance to engage with palliative care services.

“It’s hoped that through this project we will be able to improve interactions between patient and service providers, resulting in improved quality of life and lower unplanned admissions.”

As a result, patients’ needs remain unrecognised or underreported – leading to avoidable suffering and high costs of care. It’s for this reason that the project aims to establish clear, supportive care pathways within the health system to address these gaps.

“It is hoped that through this project we will be able to improve interactions between patient and service providers, resulting in improved quality of life and lower unplanned admissions,” said chief research officer at the CDIA, Associate Professor Peter Delobelle.

The project currently supports four scholarships, including one PhD candidate at Heideveld Emergency Centre, whose research focuses on reducing readmission rates among patients with advanced illness, and three MPhil students in palliative care.