…urge govt to incorporate care into NHIS
By Adeyinka Adeniran
Experts in the area of palliative care have said Nigerians have yet to harness the full potential available to patients on life limiting illnesses.
This is as they called for a collaborative efforts in the country to take care of those who are sick and whose illnesses cannot be cured.
Palliative care is a type of care focused on alleviating the symptoms, pain, and stress of serious illnesses, rather than curing the illness itself. It aims to improve the quality of life for patients and their families as patients await end to life.
The experts under the aegis of Centre for Palliative Care, spoke during a media roundtable in commemoration of the 2024 World Hospice and Palliative Care Day, Nigeria (CPCN).
According to the experts, Nigeria’s policy on palliative care services for cancer and other life-limiting illnesses is not optimally implemented as only a handful of Nigeria’s tertiary hospitals offer treatment to patients and their families who are struggling with life-threatening illnesses.
Speaking, a member of the African Palliative Care, Professor IkeOluwapo Ajayi stated lamented that the palliative care policy formulated a few years ago is yet to be fully implemented to ensure comprehensive services are available for all people that need them.
She urged the government to incorporate palliative care services into the National Health Insurance Scheme.
Ajayi, who is also the director of the Institute for Advanced Medical Research and Training (IAMRAT), disclosed that the policy was meant to get palliative care to all three tiers of government, but palliative care services are only available in some tertiary centres in Nigeria.
She said, “The policy came in about three years ago. It was meant to get palliative care to all three tiers of government and provide comprehensive care for patients. However, the implementation has been very suboptimal. We can only boast of palliative care services in some tertiary centres in Nigeria.
“Even these tertiary centres, I would say they were established with the support of the Centre for Palliative Care Nigeria. They still need more support, and we still need to establish more centres to implement the national policy on palliative care.
“Now, its implementation at the secondary and primary health care levels is nothing to write home about. There has not been integration of palliative care into these two tiers of the health care system.
“We, as the Centre for Palliative Care Nigeria, made a lot of advocacy calls to our states, our governors, and the Ministry of Health to advocate for the integration of palliative care into the secondary and primary care systems.”
Professor Ajayi highlighted other challenges to palliative care service, including poor funding for palliative care, poor political will, inaccessibility and affordability of palliative care, and a lack of awareness of its usefulness by patients and many healthcare providers.
“Palliative care, like any other care in the hospital or in any illness, requires funding. To be closer to the people, the government needs to incorporate palliative care services into the National Health Insurance Scheme.
“This is very important. The drugs are very expensive and also available. If the insurance can take care of this, many patients would access it because it’s a limiting factor for many patients, apart from poor awareness.
“Since these medications have the potential to lower patient care costs, policymakers should be made aware of their importance and value to both patients and the healthcare system. There would be many more patients who could pass away with dignity if we could advance palliative care services. As much as possible, they would pass away pain-free, and the families would lead fulfilling lives caring for their patients.”
The president of the Centre for Palliative Care, Nigeria (CPCN), Professor Olaitan Soyannwo, stated that the organisation began advocating in 2005 for effective pain relief, such as opioid painkillers, and for health professionals to receive training and resources to prevent pain and suffering in patients receiving care in the nation’s hospitals.
Prof Soyannwo urged collaborative efforts in Nigeria to take care of those who are sick and whose illnesses cannot be cured, adding, “This kind of care is not just for those who have cancer. It included people with kidney, liver, or heart problems and sickle cell disease. They are struggling and in great discomfort.
Also speaking, a consultant anaesthetist, Dr. Mukaila Akinwale said that the World Health Assembly resolution on palliative care was that each government should strengthen palliative care as a component of comprehensive care throughout the life course, with imparts already on service delivery, training, and research at University College Hospital, Ibadan.
In his own remarks, a paediatric oncologist, Professor Biobele Brown, declared that children with serious or potentially life-limiting illnesses can also benefit from palliative care, which can ease their suffering, support their families, and help them live better lives.
“In palliative care, the family can be taught how to care for this child at home and make this child happy. The unique thing about palliative care is that it goes beyond the child.
“In fact, children have a higher cancer cure rate than adults do. Palliative care should be included from the start, even if the cancer is a treatable kind. So while the experts are trying to cure it, palliative care ensures that the child is pain-free.
“Palliative treatment guarantees the child’s psychological well-being. Socially, he’s doing well. The child can attend school during the course of treatment,” he stated.
Dr Adeyinka Ishola, a pharmacist, said availability and affordability of painkiller drugs, particularly opioids, are essential for the treatment of patients in palliative care.
He stated that when taken for an extended period of time, oral morphine has been shown to be effective in treating moderate to severe pain with few to no adverse effects.
