End-of-life Care in Sub-Saharan Africa: Future Directions for Practice, Research, and Policy

End-of-life care (EOL) is an essential component of health systems, yet it remains underdeveloped in Sub-Saharan Africa (SSA) despite a growing burden of life-limiting conditions such as cancer, human immunodeficiency virus (HIV)/AIDS, and non-communicable diseases. This chapter explores the current state of EOL care in SSA, highlighting systemic, cultural, and economic barriers that limit access to quality palliative care services. Drawing on case studies from Uganda, Zimbabwe, South Africa, Kenya, and other countries, it examines innovative models such as community-based care, task-shifting, and telehealth interventions that offer scalable solutions in resource-constrained settings. The chapter identifies critical priorities such as the epidemiology of EOL needs, cost-effectiveness analysis, and implementation actions. It also outlines policy recommendations for integrating palliative care into universal health coverage (UHC), improving opioid availability, and strengthening workforce capacity. By synthesising evidence and practice insights, this chapter provides a roadmap to advance EOL care through culturally sensitive, sustainable strategies that align with global equity goals.