Stakeholders meeting and launch of situational analysis for children’s palliative care in Ghana

A stakeholder’s engagement on children’s palliative care in Ghana was held at the Ministry of Health on Wednesday 11th January 2023. The aim of the meeting was to establish and confirm the justification for the research on ‘’needs assessment and situation analysis on children’s palliative care in Ghana’’ as well as engage key informants for a Focus Group Discussion. participants attended the meeting from a range of organisations including the Ministry of HealthGhana Health Services,  Korle Bu Teaching HospitalKomfo Anokye Teaching HospitalTamale Teaching HospitalCape Coast Teaching HospitalHo Teaching Hospital,  Holy Family Hospital, Greater Accra Regional HospitalPrincess Marie Loius Hospital, Tetteh Quarshie Memorial Hospital, Lifeline for Childhood Cancerthe University of Ghana, the Ghana College of Physicians and Surgeons, the Ghana College of Nurses and Midwives, the Nursing and Midwifery Council of Ghana, the Medical and Dental CouncilClinton Health Access Initiative, the Paediatric Society of Ghana, and the Ghana Palliative Care Association.

The meeting was opened by the Special Advisor to the Minister of Health Dr Baffour Awuah, who is a Radiation Oncologist by profession. He welcomed people on behalf of the Minister of Health and stressed the importance of palliative care for children in Ghana. Late diagnosis of many conditions is a challenge in Ghana and so palliative care is essential, but it is also important to look at how we can improve early detection to enable more children to survive. Whilst it is important to address palliative care for children, we need to address palliative care for all and need a strategy for palliative care that will cover the whole country and across the age continuum. He stressed that it is important to get it right at the beginning and hopes that the situational analysis on children’s palliative care in Ghana will provide recommendations to help guide the development of a comprehensive plan for palliative care in Ghana

Prof Lorna Renner, Professor University of Ghana and Paediatrician at Korle Bu Teaching Hospital, then discussed childhood cancer in Ghana. She took us back to the beginning of childhood cancer treatment in Ghana and showed the changing pattern of childhood cancer within the country. Currently around 50% of children with cancer in Ghana are cured, and it is important that we provide palliative care for those who don’t survive, as well as increasing the survival rate for childhood cancer within the country. Ghana was one of the first countries involved in the WHO Global Initiative for Childhood Cancer (GICC) and the management of four childhood cancers is now covered by the health insurance with ongoing discussions about others. Despite challenges, such as the lack of national data, there has been much progress in childhood cancer in recent years including the development of national treatment guidelines and a national childhood cancer strategy.

The situation of palliative care in Ghana was then discussed by Dr Edwina Beryl Addo Opare-Lokko, a palliative care specialist physician from the Greater Accra Regional Hospital, the Ghana College of Physicians and Surgeons and the Ghana Palliative Care Association. She took participants through the definition of palliative care, its beginnings by Dame Cicely Saunders, and progress within Ghana. She talked about the need for everyone to have some training in palliative care, with some being trained as specialists. Currently in Ghana there are 5 specialist palliative care doctors, one of whom is a paediatric palliative care specialist, 20 palliative care clinical nurse specialists and 5 palliative care nurses with PhDs. Whilst this is great, it is not nearly enough to ensure that all people in need of palliative care in Ghana can access it. She also discussed some of the key areas for the development of palliative care in Ghana such as implementation, education, access to medicines, research and policy. There are various initiative taking place for palliative care within Ghana and it is important that these are co-ordinated, that there is ongoing collaboration between all stakeholders, including the Ghana palliative care association.

After break Prof Julia Downing, Chief Executive of the International Children’s Palliative Care Network (ICPCN) provided an overview of children’s palliative care globally and in Africa. She discussed the need for children’s palliative care, which children need access to palliative care, the importance of providing care from diagnosis through the continuum of care and ensuring continuity of care across different services. Having identified some of the global health perspectives key to the development of palliative care such as the Lancet Commission report, the WHA assembly resolution, the sustainable development goalsuniversal health coverage and the Declaration of Astana, she then went on to look at progress within Africa, and how challenges can be overcome utilising the WHO conceptual framework for palliative care. She then shared examples of work on children’s palliative care commenced in Africa that is having global impact such as the development of a Children’s Palliative Outcome Scale (C-POS), and the estimation of need for children’s palliative care. Finally, she shared the aims of the needs assessment and situational analysis for children’s palliative care that is being funded by World Child Cancer and being conducted in conjunction with the Ministry of Health, Ghana Health Services, Korle Bu Teaching Hospital, Komfo Anokye Teaching Hospital and ICPCN.

The meeting was closed by Pinamang Boateng Desu, Country Coordinator of World Child Cancer, and Emmanuel Ayire Adongo, Regional Co-ordinator for sub-Saharan Africa at World Child Cancer, who discussed the next steps and the commencement of the situational analysis for children’s palliative care in Ghana.