First pain management programme introduced in The Gambia, Kenya, and Malawi

A vital new initiative, aimed at improving pain management among palliative care patients receiving hospital care, has been launched by the FHSSA (an affiliate of the US-based, National Hospice and Palliative Care Organisation) and the African Palliative Care Association (APCA) in The Gambia, Kenya, and Malawi.

One of the key challenges of pain management identified by the partnering organisations was the limited understanding of the palliative care concept and the need for palliative care services by hospital-based health care workers.

The FHSSA’s Executive Director, John Mastrojohn, comments: “Often, physicians are not comfortable in effectively prescribing opioids, such as morphine. This can be due to lack of skills in pain assessment and management, coupled with fears around the use of these powerful medications.”

The project framework is based on a successful pilot project in Uganda that was endorsed by the World Health Organisation and the Ugandan Ministry of Health. The Gambia, Kenya and Malawi were selected to participate in the launch pain management programme because of their well-established national palliative care organisations, strong clinical leadership, historical success with related projects, and sound professional relationships with APCA and FHSSA staff/leadership.

Professor Scott Murray, St Columbia’s Hospice Chair of Primary Palliative Care in Edinburgh is familiar with palliative care developments in Africa and believes the project will be incredibly valuable:

“The recent audit of patients in Mulago, Uganda’s main hospital, revealed that many patients had palliative care needs and most were unmet. This was even before the national stock-out of morphine for three months last year.

“This project will further seek to integrate palliative care in other African hospitals, and this is most welcome.  In so doing, it will sensitise other health workers, and hopefully lead to established hospital based teams.”

Separate funding from the Princess Diana Memorial Fund has been negotiated for development of hospital palliative care in Uganda.

Learn more about the work of FHSSA at

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