PEPFAR public health evaluation: Palliative care

APCA is working with King’s College London (KCL), Measure Evaluation and PEPFAR to conduct this targeted evaluation.  The APCA team is comprised of: Dr Julia Downing (budget holder and Principal Investigator); Richard A. Powell (M&E and Research Manager); Eve Namissango (Research Coordinator) and six research assistants: Geoffrey Banga; Clare Nsubuga, Jeniffer Kataike (based in Kampala, Uganda) and Nancy Gikaara, Grace Munene and Mackuline Atieno (based in Nairobi, Kenya).

Why conduct an evaluation?

With enormous efforts going toward treatment and care for HIV / AIDS patients under the PEPFAR programme, appreciating the outcomes and effects of palliative care programmes is critical to informing current and future programme design, as well as the allocation of human and financial resources. Unfortunately, despite experience in resource-poor palliative care programmes under PEPFAR, there exists little evidence differentiating what packages of services work best, for whom and in what circumstances. The Palliative Care Public Health Evaluation (PC-PHE) is designed to begin addressing this gap.

Objectives of the Evaluation?

There are three primary objectives of the PC-PHE:

1. To assess different packages of services and costs of palliative care with standard outcomes;
2. To evaluate how specific components included in palliative care packages of services are related to outcomes achieved;
3. To disseminate ‘lessons learned’, best practices and to provide recommendations for scale-up and mid-course PEPFAR corrections identified through the evaluation.

How will the results be used?

Based on this PC-PHE, we expect results to help guide future programme decisions by providing information on the following:

• Policy Makers: Information on the types of palliative care programmes and the health outcomes they influence will assist legislators, parliamentarians, and national health officers in their development of evidence-based palliative care policies and protocols.

• Advocacy Groups: Data on services such as psychosocial counselling and socio-economic and bereavement care that promote quality of life for PLWHAs and their families will provide advocates, such as APCA and local palliative care and PLWHA groups, with information on how to best promote the inclusion of these services in palliative care packages.

• Program Managers: Program managers involved in the implementation of palliative care services will have access to data on best practices in working with community health workers, clinical services for opportunistic infections and pain management and referral networks. In addition, findings from the evaluation concerning organisational factors contributing to the quality of these services can be used to identify actions for strengthening service provision.

• Program Planners: The cost of specific palliative care services and packages will provide information that supports the identification, targeting and allocation of resources for more effective programme planning. Information on the effectiveness of services based on demonstrated health outcomes will assist programme managers and planners as they work together to identify and implement a palliative care programme.

For the researchers reflections on the completion of the first phase of the study, read more....

For the phase 1 findings shared in Kampala and Nairobi in mid -2008, read more.....

For more information, please contact eve.namissango@apca.co.ug.