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Integration and delivery of palliative and supportive care.

Domaine:

healthcare
Créateur:
FreJosGerChr
Éditeur:
Ame
Hôte:
97 Background: Pediatric palliative care (PC) and end-of-life (EoL) planning and support for children, families, and providers are under-developed in Kenya. PC providers in Kenya want to build advocacy and teams to support children with life-threatening or limiting diseases and their families. Methods: KEHPCA in collaboration with UoN/KNH and US pediatric PC providers solicited applications from across the country to participate in a weeklong “train-the-trainer” workshop. The program was entirely devoted to pediatric PC and EoL care and is the “first-like” workshop to our knowledge. The program incorporated a variety of teaching and training tools that were used to support children, their families and caregivers suitable for the Kenyan setting. The cases of 7 children (7 mos. to 11 yrs) served as the focal point for training including extensive role-play scenarios. Results: The workshop convened 9-13 th July 2018 in Nairobi. KEHPCA selected 31 providers from among 130 across Kenya to participate and included medical officers, nurses, pharmacists, psychosocial workers, spiritual care, and a school teacher. Expectations were identified by participants at the start, pre- and post-conference surveys were completed, and the identical survey was submitted twice to more than 5,000 physicians listed in the Kenya Board of Medicine directory. There is a lack of awareness of the importance of PC by physicians listed in the directory responding to the same survey. The workshop was well received and ways forward identified. Conclusions: There is consensus among participants that there are five critical gaps in pediatric PC in Kenya: 1) PC requires an interdisciplinary team; 2) interdisciplinary family visits are seldom done; 3) there is a need to facilitate EoL and serious illness conversations with families/guardians and children as appropriate (adolescents in particular); 4) identify ways to support the legacy of infants and young children who pass away; and 5) a clear desire to support the healthcare team. These observations will form a solid departure point for developing programs and ways forward for Kenyan children with life-threatening illnesses. [Supported in part by: KEHPCA and NIH grant nos.: D43 TW009333.]

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