Challenges and opportunities for strengthening palliative care services in primary healthcare facilities: perspectives of health facilities in-charges in Dar es Salaam, Tanzania
- PMID: 39448220
- PMCID: PMC11499778
- DOI: 10.1136/bmjopen-2024-085746
Challenges and opportunities for strengthening palliative care services in primary healthcare facilities: perspectives of health facilities in-charges in Dar es Salaam, Tanzania
Abstract
Background: With the rise of non-communicable diseases in Tanzania, palliative care (PC) is increasingly needed to improve the quality of life for these patients through pain and symptom management and providing psychological care, social and spiritual support. Despite a larger portion of the population having access to healthcare services at primary healthcare (PHC) facilities in Tanzania, PC services are limited and less organised at this level. This study explored the challenges facing the provision of PC and the opportunities for strengthening PC services at PHC facilities in Tanzania.
Methods: We adopted an exploratory qualitative case study to conduct in-depth interviews with 15 health facilities in charge from 15 purposefully selected PHC facilities in Dar es Salaam City, Tanzania, in August 2023. We analysed the gathered information using qualitative content analysis.
Results: Two categories emerged from the analysis of the gathered information. These are (1) challenges facing the provision of PC services at PHC facilities and (2) opportunities for strengthening PC services at PHC facilities. The challenges are grouped as provider-level, facility-level and patient-level challenges. The opportunities are organised into three subcategories. These are the increasing demand for PC services, the availability of multiple supporting systems and a functional referral system.
Conclusion: This study underscores the challenges and opportunities for providing PC services at PHC facilities. These findings call for a collaborative effort from health system players to strengthen the available PC services. The efforts should include expanding the coverage of PC services at the PHC facilities and healthcare providers' training. Expansion of PC services should include introducing them in places where they are unavailable and improving them where they are not available. PC training should consider preservice training in the health training institutions' curricula and continued medical education to the existing staff. Furthermore, we recommend community health education to raise awareness of PC services.
Keywords: Adult palliative care; Palliative Care; Primary Health Care.
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Conflict of interest statement
Competing interests: None declared.
Similar articles
-
Patients' and Care Providers' Reported Barriers and Suggestions for Improving HIV Viral Load Testing in Tanzania: A Qualitative Study in Dar es Salaam.J Int Assoc Provid AIDS Care. 2024 Jan-Dec;23:23259582241273385. doi: 10.1177/23259582241273385. J Int Assoc Provid AIDS Care. 2024. PMID: 39161244 Free PMC article.
-
Why caretakers bypass Primary Health Care facilities for child care - a case from rural Tanzania.BMC Health Serv Res. 2011 Nov 17;11:315. doi: 10.1186/1472-6963-11-315. BMC Health Serv Res. 2011. PMID: 22094076 Free PMC article.
-
The acceptability of integrated healthcare services for HIV and non-communicable diseases: experiences from patients and healthcare workers in Tanzania.BMC Health Serv Res. 2022 May 16;22(1):655. doi: 10.1186/s12913-022-08065-4. BMC Health Serv Res. 2022. PMID: 35578274 Free PMC article.
-
A modified systematic review of the impact of cultural beliefs on the acceptability and accessibility of adult palliative care in Tanzania.Int J Palliat Nurs. 2025 Feb 2;31(2):68-80. doi: 10.12968/ijpn.2025.31.2.68. Int J Palliat Nurs. 2025. PMID: 39969902
-
Assessing public-private procurement practices for medical commodities in Dar Es Salaam: a situation analysis.BMC Health Serv Res. 2022 Dec 14;22(1):1523. doi: 10.1186/s12913-022-08923-1. BMC Health Serv Res. 2022. PMID: 36517787 Free PMC article. Review.
References
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous