Toward enhanced decentralized palliative care services in Neno District, Malawi: a qualitative study.

• DOI: 10.1186/s12904-024-01455-x
• Publication Date: 2024-05-23T02:01:34Z
• Authors: Atupere S. Phiri; Manuel Mulwafu; Haules Robbins Za...; Moses Banda Aron; Judith Kanyema; Stellar Chibvunde; Enoch Ndarama; Grace Momba; Fabien Munyaneza; Lameck Thambo; Chiyembekezo Kach...; Beatrice Matanje
• Keywords: Male; Adult; Malawi; Family medicine; FOS: Political science; Health Professions; Social Sciences; FOS: Law; Nursing; FOS: Health sciences; Health Services Accessibility; Focus group; FOS: Economics and business; Psychological Impact of Bereavement and Grief; Sociology; Qualitative research; Health Sciences; Humans; Psychology; Business; Political science; Qualitative Research; Aged; Marketing; And Rural Health Services; Shared Decision Making in Healthcare; Research; Health services accessibility; Palliative Care; Politics; Public Health, Environmental and Occupational Health; Decentralization; Health care; RC952-1245; Integration of Palliative Care in End-of-Life; Quality of Dying; Health personnel; Focus Groups; Middle Aged; Social science; FOS: Sociology; FOS: Psychology; Clinical Psychology; Special situations and conditions; General Health Professions; Palliative care; Medicine; Female; Law

Abstract Background Palliative care remains key in assisting patients who have life-threatening conditions. In most low- and middle-income countries, it is often offered through a centralized system with limitations, including Malawi. 2014, the World Health Organization called for improving palliative access primary health community models. Malawi Neno District subsequently decentralized delivery to local centers. This qualitative study explored decentralization of services District, Methods The descriptive was conducted between 2021 2022 two conveniently selected centers providing District. Fourteen healthcare workers were purposefully participate focus groups. Fifteen participated three Data analyzed using deductive inductive approaches. Focused group discussions Chichewa (Malawi’s official language), audio recorded, transcribed, translated into English, thematically. Results Four main themes emerged from Patients described positive relationships built on trust holistic over time. Accessing included transport, social support, time constraints, distance issues. Facilities effectively responded needs coordinated follow-up. Decentralization perceived benefit by reducing travel challenges efficient inclusive services. However, resources, distance, support remained. Limitations sampling missing participant details necessitate further research broader sampling. Conclusion Overall, provides empirical evidence that can optimize similar low-resource contexts informing policies address barriers