Kenya is among the countries missing on the list of countries worldwide that have palliative care well integrated into the health systems.

Only 20 countries worldwide have palliative care well integrated into their healthcare systems according to the unmet need in palliative care mapped for the first time in the Global Atlas for Palliative Care at the End of Life, Published jointly by the World Health Organization (WHO) and the Worldwide Palliative Care Alliance (WPCA).

Among the challenges leading to this positioning is the lack of stand-alone palliative care policy in the country that could offer guidance in this integration.

Despite these challenges, Kenya has made tremendous steps towards realizing integration of palliative care into the health systems.

Continued advocacy has seen 11 Level 5 Hospitals integrate this service in the initial phase with 30 Level 4 (district) hospitals in the lineup for the second phase of integration.

A few district hospitals have followed suit by establishing palliative care units and more would match up this need following a recent directive from the Ministry of Health (MoH) to 15 district hospitals to set aside space and recourses to establish palliative care.

The MoH has since agreed to purchase morphine, an essential drug in pain management, for government hospitals that have integrated palliative care.

In the last quarter of 2013, 2.2kgs of the 22kg morphine procured through Laborex Limited Kenya was received in the country by the Kenya Medical Supplies Agency (KEMSA).

KEMSA has already realigned itself to the new devolution structure of governance in Kenya and is set to supply morphine as per requests from hospitals.

In tackling lack of knowledge about palliative care, Kenya Hospices and Palliative Care Association (KEHPCA) has continuously offered training to health care providers through workshops, Continuous Medical Education (CMEs) in hospitals that have and are planning to integrate palliative care services.

KEHPCA has used the Training of Trainers (ToT) approach to enable more health care providers receive the prerequisite knowledge to bridge the gap existing between the service providers and the need for palliative care services.

After a year of crafting documents by experts from the Kenya Medical Training College (KMTC), KEHPCA and the Nursing Council of Kenya, a palliative care curriculum was developed that led to the commencement of a Higher Diploma in Palliative Care Course at KMTC in September 2013.

The first group comprised of ToTs who would in turn train more students pursuing health courses in other Medical Training Colleges across the country.

In addition to this course, Nairobi Hospice in conjunction with Oxford Brookes University is offering a Higher Diploma in Palliative Care Course aimed at cushioning the country of the need for qualified palliative care providers.

There are still challenges of lack of staff in most of these units and resources that could facilitate home visits to accomplish the home care bit of palliative care.

This unmet need is mapped for the first time in the Global Atlas of Palliative Care at the End of Life, published jointly by the World Health Organization (WHO) and the Worldwide Palliative Care Alliance (WPCA).

About one third of those needing palliative care suffer from cancer. Others have progressive illnesses affecting their heart, lung, liver, kidney, brain, or chronic, life-threatening diseases including HIV and drug-resistant tuberculosis.

The Atlas calls on all countries to include palliative care as an essential component to every modern healthcare system in their moves towards universal health coverage. This means addressing barriers such as:

1) lack of policies recognizing palliative care and the need for care both at the end of life and during progressive illnesses;

2) lack of resources to implement services, including access to essential medicines, especially pain relievers;

3) lack of knowledge of health care professionals, community volunteers and members of the public about the benefits of palliative care.

Read about the launch of the atlas of the International edition of ehospice

The Atlas can be downloaded at from the publications section of the WHO website or from theWorldwide Palliative Care Alliance resources page.