Presentation on theme: "The Role of Palliative Care in HIV/AIDS Management in Botswana"— Presentation transcript:
1 The Role of Palliative Care in HIV/AIDS Management in Botswana Dr. Miriam SebegoMs. Esther Ntsayagae
2 Palliative care defined Palliative care is an approach which improves the quality of life of patients and their families facing life-threatening illness, through the prevention, assessment and treatment of pain and other physical, psychosocial and spiritual problems (WHO, 2003)
3 Principles of Palliative Care Affirms life and regards dying as a normal processNeither hastens nor postpones deathProvides relief from pain and other distressing symptomsIntegrates the psychological and spiritual aspects of careOffers a support system to help patients live as actively as possible until deathOffers a support system to help the family cope duringthe patients illness and in their own bereavement.WHO 1990
4 Components of Palliative Care Relief of symptomsPsychosocial supportEnd-of-life careCaring for caregivers
5 Why Palliative Care for People Living with HIV/AIDS (PLWHA) Changes in HIV careIncreasing body of knowledge and expanded definition of palliative careShift in the trajectory of dying from HIV/ AIDSPatient with HIV/AIDS have palliative care needs at each stage of the illness.
6 Caring for (PLWHA) in Botswana Community Home Based Care (CHBC) Established in 1996Goals of CHBCEnsure optimum level of care for all terminally ill patients in order to avoid the “dumping syndrome”.To avoid unnecessary hospital admissionsTo provide clinical care in the home including giving medicationsProvide nursing care in the home settingProvide on-going counseling service to both PLWHA and their families
7 Strengths of CHBCCommitment and structure in place to support families:Social support including provision of food basket and clinical supplies such glovesCommunity mobilizationThe established referral system between hospitals and clinics
8 Weaknesses of CHBC Quality of care provided was found to be inadequate Failure to address palliationInsufficient knowledge and skills regarding palliative care by service providersLack of country specific guidelines on palliative care in BotswanaInadequate capacity to train for palliative careIssues concerning death and dying not adequately addressed
9 Challenges of CHBC in the HAART Era The shift in illness trajectoryAdverse reactions requiring palliationPsychosocial supportPatients in transition- HIV/AIDS stigma result in some infected persons entering care later in the disease progression.-Some lack the support to adhere to a complicated medication regimen.
10 Efforts towards Addressing the Identified Challenges Incorporating palliative care into CHBC-Palliative care strategy launched by the Minister of Health in June, 2005Development of palliative care guidelinesEfforts towards training of Health care workers
11 Importance of Palliative Care in HIV/AIDS HIV/AIDS is still a leading cause of morbidity and mortality particularly in sub-Saharan AfricaHAART is still not a cure and has many side effectsMany symptoms throughout the disease impact quality of lifeComplex psychosocial issues such as psychiatric illness and substance abuseHIV/AIDS stigma- some infected person enter care later in the disease progression.
12 The Way Forward Strengthening of palliative care services Need to design and test innovate models of careDevelopment and dissemination of palliative care guidelinesImprovement of Palliative care in the acute care setting.