Kenya Hospice and Palliative Care Association (KEHPCA) has been on the cutting edge of creating awareness on pain management, for this reason KEHPCA team have been travelling to different counties within the country with the intention of training health care workers on pain management. The training is referred to as the Pain Free Hospital Initiative (PFHI) and is aided by Treat the pain which is a program under the American Cancer Society.
The program has 3 main pillars; capacity building of multidisciplinary teams of health care workers on pain management , promoting accessing to analgesics including morphine and data collection and dissemination. This program has also been implemented in other 5 countries in Africa: Uganda, Ethiopia, Rwanda, Nigeria and Swaziland. As a result of this initiative thousands of patients in pain have benefitted, hospitals are reporting double and triple increase in morphine consumption and better support from the hospital administration towards access to pain control.
In Kenya the following hospitals have successfully implemented the programs; Kenyatta National Hospital, Machakos Level 5, Aga Khan University Hospital , Kijabe Mission Hospital, Maua Methodist Hospital and Thika Level 5 Hospital. Over 80 % of staff working in these hospitals have been sensitized on various aspects of pain assessment. The following facilities are in the process of implementing the program; Moi Teaching and Referral Hospital, Kisii Teaching and Referral Hospital and Embu Level 5. KEHPCA will continue supporting these facilities to ensure they are able to reach their desired target for more patients to get their pain controlled.
KEHPCA is in partnership with the Ministry of Health, Kenyatta National Hospital (KNH) and Kenya Medical Supply Agency (KEMSA) to promote access to ready to use reconstituted morphine. KNH receives morphine powder from KEMSA which is reconstituted in oral formulations both pediatric and adult formulations. The reconstituted morphine is distributed to pain and palliative care centers in the country. Currently the morphine is being given for free but there are plans to sell it at a subsidized price to ensure there is enough revenue generated to promote sustainability.
The success of the Pain Free Hospital Initiative is attributed to the commitment of the palliative care champions implementing the program, support from hospitals administration and strong partnership between KEHPCA and American Cancer Society. “Before the program it was almost impossible to convince clinicians to prescribe opioids to patients in severe pain, the situation has really changed.” Comment from one of the palliative care champions.