DOCSLIB.ORG

An Ethical Argument for a Specific Model of Palliative Care in Nigeria

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Spring 1-1-2017 An Ethical Argument for a Specific oM del of Palliative Care in Nigeria Dozie Egbe Follow this and additional works at: https://dsc.duq.edu/etd Recommended Citation Egbe, D. (2017). An Ethical Argument for a Specific odeM l of Palliative Care in Nigeria (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/127 This One-year Embargo is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. For more information, please contact [email protected]. AN ETHICAL ARGUMENT FOR A SPECIFIC MODEL OF PALLIATIVE CARE IN NIGERIA A Doctoral Project Submitted to the McAnulty Graduate School of Liberal Arts Duquesne University In partial fulfillment of the requirements for the degree of Doctor of Healthcare Ethics By Dozie R. Egbe May 2017 Copyright by Dozie R. Egbe 2017 AN ETHICAL ARGUMENT FOR A SPECIFIC MODEL OF PALLIATIVE CARE IN NIGERIA By Dozie R. Egbe Approved November 9, 2016 ________________________________ ________________________________ Henk ten Have, MD, PhD Henk ten Have, MD, PhD Professor, McAnulty College and Professor, McAnulty College and Graduate School of Liberal Arts, Center Graduate School of Liberal Arts, Center for Healthcare Ethics for Healthcare Ethics (Committee Chair) (Center Director) (Center Director) ________________________________ (Center________________________________ Director) (CommitteeGerard Magill, Chair) PhD (CenterJoris Gielen, Director) PhD Vernon F. Gallagher Chair & Professor (CenterAssistant Director) Professor McAnulty College and Graduate School (CenterMcAnulty Director) College and Graduate School of Liberal Arts, Healthcare Ethics (Centerof Liberal Director) Arts, Healthcare Ethics (Committee Member) (Center (Committee Director) Member) ________________________________ James Swindal Dean, McAnulty Graduate School of (Committee Chair) Liberal Arts iii ABSTRACT AN ETHICAL ARGUMENT FOR A SPECIFIC MODEL OF PALLIATIVE CARE IN NIGERIA By Dozie R. Egbe May 2017 Dissertation supervised by Professor Henk ten Have, MD, PhD The need for palliative care in Nigeria is huge. But Nigeria has minimal palliative care activity that does not correspond to the great palliative care needs in the country. The great needs are heightened by poverty and poverty induced conditions. However, Nigeria has untapped sociocultural values that can boast palliative care in the country. Such values can be activated and constructively integrated in the practice of palliative care in Nigeria. This project looks back to what palliative care has been in history and in developed nations to argue for a constructive and positive manner palliative care can evolve in Nigeria to address the peculiar situation of poverty and poverty induced conditions that make palliative care patients in Nigeria vulnerable. The capacities of palliative care as found in its history and its modern practice favor the integration of sociocultural values iv and other favorable structures on ground that can boast palliative care in Nigeria. This will ensure that palliative care maintains its core meaning while integrating and injecting structures and values that are meaningful to palliative care patients in Nigeria. The specific model of palliative care in Nigeria as argued in this project, is designed to mobilize all affordable resources in a strategy that will ensure holistic care for the sick while at the same time attend to how they live not just how they die. The model also allows for easy access of care as it is designed to penetrate hard-to-reach communities of the country and to deliver care in any setting- rural or urban, in hospitals, palliative care units, or residential care homes. v DEDICATION In Blessed Memory of my loving mother Agatha Nwogbo Egbe (1926-2015). You will always be remembered and cherished. Your selfless life, unconditional love and unwavering care will be missed but not forgotten. vi ACKNOWLEDGEMENT I wish to express my immense appreciation to all those who played significant role in making this project a reality. My boundless and greatest gratitude goes to Almighty God for his protection, guidance and all his blessings. I am deeply indebted to my late bishop, Simon Akwali Okafor (Bishop Emeritus of Awka Diocese). He started me off on this academic journey when he offered me the opportunity to come to United States for further study. May he continue to rest in peace in the bosom of the lord. I am equally very grateful to his successor and my local ordinary Most Rev. Paulinus Ezeokafor who continued with the support and has not relented. My sincere thanks to my supervisor Professor Henk ten Have, MD, PhD, who painstakingly directed this project. I thank him for his time, insight and diligence in the review of this work. Equal thanks go to the committee members who went through this work and approved it. I immensely express my special thanks to my mentor in the Center for Health Care Ethics, Professor Gerard Magill, PhD. Vernon F. Gallagher Chair & Professor McAnulty College and Graduate School of Liberal Arts. His counsel, good will and motivation helped make this work a reality. Words are insufficient to express my boundless gratitude for his unparalleled support, direction, good hearth, and generosity. I equally recognize and appreciate the pain-staking effort of Anthony Ike in this work. He has always been a great friend and a pillar of support. He employed great care and thoroughness as he proofread every chapter of this work. For all these and more I will ever be grateful. I have not forgotten Peter IK Osuji who dedicate a great chunk of his time to go through some parts of this work. vii I am highly indebted and grateful to my friends John Chidi Obasi and Innocent Obelle who together with the support of my late bishop played different roles that made my coming to United States to study a reality. Their support is highly priced. I cannot forget my family immediate and extended for their prayers, good wishes and general support. I remain grateful to my siblings Edwin, Francis, Basil, Fidel, and Felicia. Their support is always a pillar of strength to me. I have immense appreciation for the family of Dozie and Regina Obiekezie whose home is my second home in America. Their resolute friendship and hospitality will always be remembered and cherished. I will also like to thank my colleagues at the office of pastoral/spiritual care of UPMC. The positive energy they bring to the work environment was very motivational. Finally, to all my great friends and well-wishers, I appreciate your support and prayers, and I say thank you. viii TABLE OF CONTENTS Page Abstract .............................................................................................................................. iv Dedication .......................................................................................................................... vi Acknowledgement ............................................................................................................ vii Chapter One: Introduction ...................................................................................................1 Chapter Two: Origin and Development of Palliative Care in Western Countries ………15 A. Palliative Care: Origin, Evolution, and Earliest Concepts……………………….16 1. Origin, and Evolution…………………………………………………….23 2. Concepts………………………………………………………………….24 i. Earliest Concepts………………………………………………...24 ii. Modern Concepts………………………………………………...28 B. Current Practice and Models……………………………………………………..32 C. Nature of Palliative Care…………………………………………………………36 Chapter Three: From Developed Nations to Developing Nations: Lessons of Palliative Care in Developed Nations for Developing Countries…………………………………..47 A. Lessons of Developed Palliative Care in Western Countries for Developing Countries…………………………………………………………………………49 1. Availability of Palliative Care…………………………………………...52 i. Advanced Pain and Symptom Management…………………….54 ii. Attention to Psychological and Spiritual Needs/Concerns of Patients and Families…………………………………………….57 iii. Development of Multidisciplinary Teams……………………….58 ix 2. Adaptations to Structures on Ground…………………………………….61 3. From Basics to More Current Pressing Issues…………………………...65 B. Status of Palliative Care in Developing Nations…………………………………67 1. Lack of Palliative Care…………………………………………………..67 i. Characteristics of a Developing Nation………………………….68 2. Palliative Care a Necessary Response…………………………………..70 i. Current Meaningful Efforts………………………………………73 ii. Additional Issues of Different Nature……………………………76 Chapter Four: Palliative Care in Nigeria………………………………………………...88 A. Nigeria as a Developing Nation……………………………………………….....88 1. Nigeria: A Developing Nation with a difference ………………………..90 i. Population, and Economic Growth……………………………....90 a. Population………………………………………………..90 b. Economic Growth………………………………………..91 ii. Disease Control…………………………………………………..92 2. Poverty and Poverty Induced Conditions………………………………..95 B. Peculiar Situation: The Double Burden of Sickness for Palliative Care Patients…………………………………………………………………………100 1. The Effects of the Peculiar Situation…………………………………...100 i. Need for Palliative Care………………………………………..100 ii. Burdens of Poverty and Diseases……………………………….101 a. Burdens of Poverty……………………………………..102 b. Burdens of Diseases/Sickness………………………….103 x iii.
Recommended publications
  • Made in the Image of God 8-9, 12-13 July 2021 | Online

    Made in the Image of God 8-9, 12-13 July 2021 | Online

    Developing Health Course Restoring Humanity: Made in the Image of God 8-9, 12-13 July 2021 | Online 1 DHC 2021 The Developing Health Course is ideally suited to update, equip and inspire people who are committed to global health, whether you are preparing to go outside of the UK to work, returning for a short break and want to update your learning, or considering whether getting involved in global health work is for you. The course materials cover strengthening healthcare systems, specific healthcare interventions as part of an integrated and multi-disciplinary setting, and learning to lead, learn and teach in such settings. The course is taught by a broad range of highly experienced and skilled healthcare professionals who have all worked in global health and mission. Our 2021 course will be in a different, non-residential format with online teaching across 4 half-days 8-9 July, 12-13 July (9am – 1pm BST), followed by a wider range of subjects in 8 sessions across the coming year (topics and dates to be determined). We encourage participation as part of this learning community throughout the year. However, the course is also open to people to join on a sessional basis. Each day also includes optional lunchtime sessions. DHC Lunchtime Options 1-2pm Thursday 8 July Virtual Mission Fair – contact [email protected] for a list of mission agencies and details of how to book a slot. Friday 9 July 1. Conversation room on Trauma led by Jes Bates 2. Conversation room on Leadership led by Addy Sitther and Dave Moore 3.
  • The Impact of Climate Variability and Conflict on Childhood Diarrhea and Malnutrition in West Africa

    The Impact of Climate Variability and Conflict on Childhood Diarrhea and Malnutrition in West Africa

    City University of New York (CUNY) CUNY Academic Works All Dissertations, Theses, and Capstone Projects Dissertations, Theses, and Capstone Projects 2-2016 The Impact of Climate Variability and Conflict on Childhood Diarrhea and Malnutrition in West Africa Gillian Dunn Graduate Center, City University of New York How does access to this work benefit ou?y Let us know! More information about this work at: https://academicworks.cuny.edu/gc_etds/765 Discover additional works at: https://academicworks.cuny.edu This work is made publicly available by the City University of New York (CUNY). Contact: [email protected] The Impact of Climate Variability and Conflict on Childhood Diarrhea and Malnutrition in West Africa by Gillian Dunn A dissertation submitted to the Graduate Faculty in Public Health in partial fulfillment of the requirements for the degree of Doctor of Public Health, The City University of New York 2016 © 2016 Gillian Dunn All Rights Reserved ii The Impact of Climate Variability and Conflict on Childhood Diarrhea and Malnutrition in West Africa by Gillian Dunn This manuscript has been read and accepted for the Graduate Faculty in Public Health to satisfy the dissertation requirement for the degree of Doctor of Public Health Deborah Balk, PhD Sponsor of Examining Committee Date Signature Denis Nash, PhD Executive Officer, Public Health Date Signature Examining Committee: Glen Johnson, PhD Grace Sembajwe, ScD Emmanuel d’Harcourt, MD THE CITY UNIVERSITY OF NEW YORK iii Dissertation Abstract Title: The Impact of Climate Variability and Conflict on Childhood Diarrhea and Malnutrition in West Africa Author: Gillian Dunn Sponsor: Deborah Balk Objectives: This dissertation aims to contribute to our understanding of how climate variability and armed conflict impacts diarrheal disease and malnutrition among young children in West Africa.
  • Advancing the Integration of Palliative Care in the National Health System

    Advancing the Integration of Palliative Care in the National Health System

    27 September 2013 An Evidence Brief for Policy Advancing the Integration of Palliative Care in the National Health System Full report Who is this evidence Included: brief for? - Description of a health system problem Policymakers, their support staff, and other stakeholders with an interest in - Viable options for addressing this problem the problem addressed by this - Strategies for implementing these options evidence brief Not included: Recommendations Why was this evidence This policy brief does not make recommendations brief prepared? regarding which policy option to choose To inform deliberations about health policies and programmes by summarizing the best available evidence about the problem and viable solutions What is an evidence brief for policy? Evidence briefs for policy bring together global research evidence (from systematic reviews*) and local evidence to inform deliberations about health policies and programmes *Systematic Review: A summary of studies addressing a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise the relevant research, and to collect and analyse data from this research Executive Summary The evidence presented in this Full Report is summarized in an Executive Summary. This evidence brief was prepared by the Uganda country node of the Regional East African Community Health (REACH) Policy Initiative . Authors Address for correspondence Harriet Nabudere, MD, MPH☼ Dr Harriet Nabudere Ekwaro Obuku, MD, MSc , FICRS-F ☼ SURE Project Coordinator Mohammed
  • Case Study of Boko Haram Insurgency in Nigeria

    Case Study of Boko Haram Insurgency in Nigeria

    Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2020 Public Policy Response to Violence: Case Study of Boko Haram Insurgency in Nigeria Emmanuel Baba Mamman Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Public Administration Commons, and the Public Policy Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Social and Behavioral Sciences This is to certify that the doctoral dissertation by Emmanuel Baba Mamman has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Timothy Fadgen, Committee Chairperson, Public Policy and Administration Faculty Dr. Victoria Landu-Adams, Committee Member, Public Policy and Administration Faculty Dr. Eliesh Lane, University Reviewer, Public Policy and Administration Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2020 Abstract Public Policy Response to Violence: Case Study of Boko Haram Insurgency in Nigeria by Emmanuel Baba Mamman MPA, University of Ilorin, 1998 BSc (Ed), Delta State University, Abraka, 1992 Final Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Policy and Administration Walden University September 2020 Abstract The violence of the Boko Haram insurgency in Nigeria has generated an increased need for public policy responses.
  • Book Censorship in Nigeria: a Study of Origin, Methods and Motivations, 1805-2018 EMMANUEL IFEDUBA Emmaifeduba@Gmail.Com

    Book Censorship in Nigeria: a Study of Origin, Methods and Motivations, 1805-2018 EMMANUEL IFEDUBA [email protected]

    University of Nebraska - Lincoln DigitalCommons@University of Nebraska - Lincoln Library Philosophy and Practice (e-journal) Libraries at University of Nebraska-Lincoln 7-31-2018 Book Censorship in Nigeria: A study of Origin, Methods and Motivations, 1805-2018 EMMANUEL IFEDUBA [email protected] Follow this and additional works at: http://digitalcommons.unl.edu/libphilprac Part of the Arts and Humanities Commons, and the Library and Information Science Commons IFEDUBA, EMMANUEL, "Book Censorship in Nigeria: A study of Origin, Methods and Motivations, 1805-2018" (2018). Library Philosophy and Practice (e-journal). 1954. http://digitalcommons.unl.edu/libphilprac/1954 Book Censorship in Nigeria: A study of Origin, Methods and Motivations, 1805-2018 By Emmanuel Ifeduba Redeemer’s University, Ede, Osun State, Nigeria Email: [email protected] Phone: 234 803821430 Abstract Twenty-first century Nigeria may be described as the era of democracy yet freedom to publish, which is one of the hallmarks of true democracy, seem to be endangered more than ever before. Conversation around this subject has, however, been superficial, lacking in both historical and empirical depth. The aim of this study, therefore, is to investigate the origin, methods and motivations of censorship in Nigeria with a view to deepening the understanding of this phenomenon. Quantitative and qualitative data were collected offline and online using document analysis and interviews were analysed by simple percentages and the constant comparative method. Findings indicate that book censorship began in 1805, over two centuries ago. Eleven methods, including, burning, banning and bombing have been employed and three major motivations (political, religious and socio-cultural) were identified.
  • Made in the Image of God 8-9, 12-13 July 2021 | Online

    Made in the Image of God 8-9, 12-13 July 2021 | Online

    Developing Health Course Restoring Humanity: Made in the Image of God 8-9, 12-13 July 2021 | Online DHC 2021 The Developing Health Course is ideally suited to update, equip and inspire people who are committed to global health, whether you are preparing to go outside of the UK to work, returning for a short break and want to update your learning, or considering whether getting involved in global health work is for you. The course materials cover strengthening healthcare systems, specific healthcare interventions as part of an integrated and multi-disciplinary setting, and learning to lead, learn and teach in such settings. The course is taught by a broad range of highly experienced and skilled healthcare professionals who have all worked in global health and mission. Our 2021 course will be in a different, non-residential format with online teaching across 4 half-days 8-9 July, 12-13 July (9am – 1pm BST), followed by a wider range of subjects in 8 sessions across the coming year (topics and dates to be determined). We encourage participation as part of this learning community throughout the year. However, the course is also open to people to join on a sessional basis. Each day will also include time for informal lunchtime discussion in breakout rooms from 1- 2pm, with a choice of 3-4 topics. One of these days will additionally include the chance to chat with mission agencies. AIMS OF THE JULY DAYS 1. To provide an interactive but virtual environment to promote learning regarding global health challenges 2. To provide a context, where along with other Christians, you can learn from experienced tutors in their specialist subjects 3.
  • Chronic Heart Failure Patients' Understanding and Beliefs of Their Illness and Its Treatment

    Chronic Heart Failure Patients' Understanding and Beliefs of Their Illness and Its Treatment

    RESEARCH ARTICLE `I think my body has become addicted to those tablets'. Chronic heart failure patients' understanding of and beliefs about their illness and its treatment: A qualitative longitudinal study from Uganda Elizabeth Namukwaya1*, Scott A. Murray2, Julia Downing1, Mhoira Leng1, Liz Grant3 1 Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda, 2 Primary a1111111111 Palliative Care Research Group, The Usher Institute of Population Health Sciences & Informatics, The a1111111111 University of Edinburgh, Medical School, Edinburgh, United Kingdom, 3 Global Health Academy, The Usher a1111111111 Institute of Population Health Sciences & Informatics, The University of Edinburgh, Medical School, a1111111111 Edinburgh, United Kingdom a1111111111 * [email protected] Abstract OPEN ACCESS Citation: Namukwaya E, Murray SA, Downing J, Background Leng M, Grant L (2017) `I think my body has become addicted to those tablets'. Chronic heart Patients with heart failure in Uganda present for health care with advanced structural heart failure patients' understanding of and beliefs about disease, have repeated hospitalizations and poorly controlled disease symptoms. The rea- their illness and its treatment: A qualitative longitudinal study from Uganda. PLoS ONE 12(9): sons for these are unclear. Literature from other settings shows that patients' understanding e0182876. https://doi.org/10.1371/journal. of their illness and their beliefs influence their health related behaviour. The study aimed to pone.0182876 explore the beliefs of patients with heart failure, their understanding of their illness and its Editor: Christophe Leroyer, Universite de Bretagne treatment, and how this influenced their health related behaviour to inform future health edu- Occidentale, FRANCE cation programs, information and palliative care services.
  • Humanitarian Bulletin

    Humanitarian Bulletin

    Humanitarian Bulletin Nigeria Issue 03 | 01 May 2013 In this issue Humanitarian aid to Baga victims P.1 HIGHLIGHTS Report on fatalities and displacement P.1 Floods early warning; 32 states at risk P.3 At least 446 fatalities Improving data collection & IDP Profiling P.5 and 22,000 IDPs recorded in April from inter communal conflict, political crisis, disaster and insurgency. 32 out of 36 states in Nigeria expected to experience flooding in Humanitarian aid provided to victims of Borno 2013 State gun battle 296,500 children under- 5 estimated to be The Government of Nigeria has deployed the National Emergency Management Agency affected by severe acute (NEMA) and federal health agencies to liaise with the Borno State government to provide malnutrition in 2013 immediate relief; including medical support and food aid to people affected by the fighting 636 suspected Lassa at Baga, a north-eastern town along the shores of Lake Chad in Borno State, close to the Fever and 22,340 border with the Republic of Chad. suspected cases of Measles reported The fighting commenced on Friday18 April, between suspected insurgency groups and the Nigerian Security forces stationed in Baga. While figures on fatalities vary, the Borno North Senatorial District puts the death toll at 228 with 2,000 houses destroyed in the KEY FIGURES violence making it the worse in the series of violent incidents that has rocked the state this year. Much of the town remains deserted after the fighting which also reportedly Nb. of children <5 296 500 estimated affected displaced 10,000 people.
  • A Publication of the British Pain Society PAIN NEWS

    A Publication of the British Pain Society PAIN NEWS

    DECEMBER 2013 VOLUME 11 ISSUE 4 DECEMBER 2013 VOLUME 11 ISSUE 4 ISSUE 11 VOLUME 2013 DECEMBER pain news a publication of the british pain society PAIN NEWS PAIN CYMBALTA® (DULOXETINE) ABBREVIATED PRESCRIBING increase in blood pressure. For patients who experience a sustained increase in failure, hepatitis, acute liver injury, angioneurotic oedema, Stevens-Johnson INFORMATION Presentation Hard gastro-resistant capsules, 30mg or 60mg of blood pressure while receiving duloxetine, consider either dose reduction or syndrome, trismus, and gynaecological haemorrhage have been made. Cases of duloxetine. Also contains sucrose. Uses Treatment of major depressive disorder. gradual discontinuation. Caution in patients taking anticoagulants or products suicidal ideation and suicidal behaviours have been reported during duloxetine Treatment of generalised anxiety disorder. Treatment of diabetic peripheral known to affect platelet function, and those with bleeding tendencies. therapy or early after treatment discontinuation. Cases of aggression and anger neuropathic pain (DPNP) in adults. Dosage and Administration Major Hyponatraemia has been reported rarely, predominantly in the elderly. Caution have been reported, particularly early in treatment or after treatment Depressive Disorder Starting and maintenance dose is 60mg once daily, with or is required in patients at increased risk for hyponatraemia, such as elderly, discontinuation. Cases of convulsion and tinnitus have been reported after without food. Dosages up to a maximum dose of 120mg per day have been cirrhotic, or dehydrated patients, or patients treated with diuretics. treatment discontinuation. Discontinuation of duloxetine (particularly abrupt) evaluated from a safety perspective in clinical trials. However, there is no clinical Hyponatraemia may be due to a syndrome of inappropriate anti-diuretic commonly leads to withdrawal symptoms.
  • Palliative Care and Mental Health How a Palliative Care Movement Has Grown to Be Inclusive of Its Needs in Kerala, Southern India

    Palliative Care and Mental Health How a Palliative Care Movement Has Grown to Be Inclusive of Its Needs in Kerala, Southern India

    9th&10th August 2018 ‘Building Momentum’ Makerere and Mulago PC Unit 10th anniversary • Dr. Chitra Venkateswaran is founder/clinical director of Mehac Foundation, in Kerala India, a not for profit palliative care mode for mental health. She also devotes her time to the palliative care, with emphasis on psychological health • Dr Chitra is also a Professor in Psychiatry, Consultant in Psycho- oncology, Department of Palliative Medicine, Amrita Institute of Medical Sciences, Kochi and National Faculty, Indian Association of Palliative Care • She is also involved in Bioethics, Cairdeas UK and National Advisory Board, Indian Journal of Palliative Care • Graduate, International Palliative Care Leadership Development Initiative, San Diego • Contributor for the development of Palliative Tool kit by Help the Hospices, UK PALLIATIVE CARE AND MENTAL HEALTH HOW A PALLIATIVE CARE MOVEMENT HAS GROWN TO BE INCLUSIVE OF ITS NEEDS IN KERALA, SOUTHERN INDIA Dr Chitra Venkateswaran, MD Professor in Psychiatry, Consultant in Psycho Oncology, Clinical Director Mehac Foundation, Kochi, Kerala, India Member, Board of Directors, International Association of Hospice and Palliative Care Honorary Senior Research fellow, Hull Medical School, UK Kampala 10/08/2018 2/3 of the country’s 300 Kerala palliative care centres and where service is available in every district, it is in the category of approaching 4a World Health Organization Collaborating Centers • Policy, research and training institution of Pain Institute of Palliative Medicine and Palliative Care Kozhikode Society, Calicut, Kerala • WHOCC for ‘Training and Policy on access to Pain Relief Models of care Total care Integration • with Kerala Cancer Model centres - community-based model of delivery of care - Urban setting outpatient-based and home based cares - Home-based care - Establishing psycho oncology models for patients with chronic illnesses in distress, and their caregivers Hospice - Multidisciplinary team Hospitals - Supported by volunteers - Hospice and hospital- - Empowering families based palliative care to patients.
  • Nigeria: Background Information, Including Actors of Protection, and Internal Relocation 9 June 2015

    Nigeria: Background Information, Including Actors of Protection, and Internal Relocation 9 June 2015

    Country Information and Guidance Nigeria: Background information, including actors of protection, and internal relocation 9 June 2015 Preface This document provides supporting guidance to Home Office decision makers on handling claims made by nationals/residents of - but is predominantly country of origin information (COI) about - Nigeria. It must be read in conjunction with the subject-specific country information and guidance reports. Public versions of these documents are available at https://www.gov.uk/government/collections/country-information-and-guidance Decision makers must consider claims on an individual basis, taking into account the case specific facts and all relevant evidence, including: the guidance contained with this document; the available COI; any applicable caselaw; and the Home Office casework guidance in relation to relevant policies. Country Information The COI within this document has been compiled from a wide range of external information sources (usually) published in English. Consideration has been given to the relevance, reliability, accuracy, objectivity, currency, transparency and traceability of the information and wherever possible attempts have been made to corroborate the information used across independent sources, to ensure accuracy. All sources cited have been referenced in footnotes. It has been researched and presented with reference to the Common EU [European Union] Guidelines for Processing Country of Origin Information (COI), dated April 2008, and the European Asylum Support Office’s research guidelines, Country of Origin Information report methodology, dated July 2012. Feedback Our goal is to continuously improve the guidance and information we provide. Therefore, if you would like to comment on this document, please email: [email protected].
  • Beating Pain

    Beating Pain

    African Palliative Care Association Beating Pain A Pocket Guide for Pain Management in Africa Beating Pain A Pocketguide for Pain Management in Africa EDITORS This guide has been edited by: · Dr Julia Downing · Mackuline Atieno · Stephanie Debere · Dr Faith Mwangi-Powell · Dr. Henry Ddungu · Fatia Kiyange LIST OF CONTRIBUTORS Contributors to this pocket guide are APCA staff and members. These include: · Dr Renee Albertyn, Red Cross Children’s Hospital, Cape Town, South Africa · Dr Henry Ddungu, African Palliative Care Association, Kampala, Uganda · Dr Julia Downing, African Palliative Care Association, Kampala, Uganda · Dr Liz Gwyther, Hospice and Palliative Care Association of South Africa, Cape Town, South Africa · Dr Jack Jaqwe, Hospice Africa Uganda, Kampala, Uganda · Dr Zipporah Merdin-Ali, Kenya Hospice and Palliative Care Association, Nairobi, Kenya · Dr Faith Mwangi-Powell, African Palliative Care Association, Kampala, Uganda · Dr Liz Namukwaya, Mulago Hospital Palliative Care Team, Kampala, Uganda · Lameck Thambo, Palliative Care Association of Malawi, Lilongwe, Malawi. African Palliative Care Association Pages 02-03 APCA is also grateful to the following people besides the editorial team for reviewing the pocketguide and providing input to the editors: Rose Kiwanuka, Dr Mhoira Leng, Dr Michelle Meiring, Patricia Ulaya, Dr Steve Williams, Dr Henry Ddungu, Dr Andrew Fullem and Dr John Palen. APCA also thanks all of its members and those on the advisory team for the AIDSTAR project: Mackuline Atieno (APCA), Stephanie Debere (APCA), Dr Henry Ddungu (APCA), Dr Julia Downing (APCA), Fatia Kiyange (APCA), Dr Faith Mwangi-Powell (APCA), Richard A Powell (APCA), Kath Defillipi (South Africa), Olivia Dix (UK), Eunice Garanganga (Zimbabwe), Carla Horne (South Africa), Jennifer Hunt (Zimbabwe), Dr Ekie Kikule (Uganda), Joan Marston (South Africa), Dr Michelle Meiring (South Africa), Dr Zipporah Merdin-Ali (Kenya), Dr Jennifer Ssengooba (Uganda), Lameck Thambo (Malawi), Patricia Ullaya (Zambia) and Dr Stephen Williams (Zimbabwe).