Background: One key issue in delivering effective palliative care in resource-poor countries is access to suitably qualified professionals or skilled workers for care (Dungu, 2011), with the resultant burden of responsibility falling on family caregivers (Salifu, Almack, & Caswell, 2020). Furthermore, palliative care provision in Africa is being overwhelmed by the COVID-19 pandemic (Oluyase et al., 2020), a situation that is forecast to be compounded due to inadequate health facilities for its management and delivery (Salifu et al, 2020). Models of palliative care delivery developed in the West may not be readily transferable to other countries such as Ghana.
A viable model within a resource-constrained continent might be based on a concept built around a philosophy of “compassionate communities”, a community-led model of palliative care that:
i. provides a naturally occurring filial supportive network;
ii. people and established organisations within the community are supported to be creative, active and resourceful and where local expertise is signposted and developed;
iii. reduces the inequity of access to care provision;
iv. builds stronger integrated collaborative partnerships between the health care system and the local communities (Abel, 2018; Aoun et al., 2020);
v. focuses on sustainable outcomes rather than Key Performance Indicators.
Such culturally and socially created communities offer opportunities for transformative holistic and compassionate care underpinned by cherished shared values. Patients could access the best palliative care support where they prefer it, and delivered by those they choose to be with during their last days of life, regardless of age or gender.
Aim: To determine whether the Westernised palliative care model is applicable in Ghana, to identify what challenges exist in providing good palliative care that is integrated with mainstream health provision, and examines culturally appropriate compassionate communities’ model of palliative This project will be a three-stage study to:
Stage 1: Conduct a systematic review of the models of, access to, outcomes from, and satisfaction with, palliative care provision in Africa.
Stage 2: Conduct an empirical qualitative study to explore the experiences of care staff in employing the Western model of palliative care, and the challenges they have experienced.
Stage 3: Explore the feasibility of the use of compassionate communities in the management of patients with palliative and end-of-life care needs and its direct benefit to the wider health and social care model in terms of outcomes (health and financial) delivered.
Method: This will be a qualitative study (Creswell & Poth, 2016) exploring the experiences of health care professionals, skilled workers/volunteers - involved in palliative care in Ghana. The study will explore the views of health care workers, cancer support groups, non-cancer end of life patients and identifiable patient/caregiver groups. Since there is no funding for travel, the research is facilitated through the support of the field supervisor, who will negotiate access and recruitment of eligible participants. The field supervisor will support local ethics applications. The established access to the identifiable participants' groups and the unique role of the field supervisor in this study contributes to the practicality of this study as a ‘PhD size’ project deliverable within the three-year PhD studentship.
Applications should be made directly to Dr Yakubu Salifu at [Email Address Removed] and should include:
1. CV (max 2 A4 sides), including details of two academic references
A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)
Data Collection: All interviews will be conducted via Skype/Teams and where relevant, via phones. Building upon pre-existing research links to palliative care staff in Ghana, we can facilitate the study progress as planned. Health care professionals and care/support groups interviews will undergo thematic analysis (Braun & Clarke, 2012).
Potential Impact: Improve the quality of life using a model of care which is context-specific, culturally appropriate, cost-effective and accessible to many (Young, 2005; Merriman, 2010). The ‘new’ palliative care model will be family/community centred, will rekindle the sense of filial piety and reciprocity of care, which is cherished in such context. This model of care will be useful in decongesting health facilities, especially in pandemics such as COVID-19, to collaborate and integrate palliative care with the conventional health care system (Dunleavy et al., 2021).