(Photo of Prof Julia Downing, Chief Executive of ICPCN, Ayire Adongo, Regional Co-ordinator for sub-Saharan Africa World Child Cancer and Dr AK Anderson, Chair of the APPM)
To build capacity for children’s palliative care in Ghana (#ChilPalCare Ghana)
At the end of January our one-year project to build capacity for CPC in Ghana came to an end. And what a year it has been. We reached over 2,500 health professionals across the country and have lit the fire for developing children’s palliative care in at least 60 healthcare facilities in every region of Ghana.
Background
The project was one of seven in Ghana funded by THET (now Global Health Partnerships) and was co-led by ICPCN and World Child Cancer-Ghana. It was a perfect partnership, with WCC-Ghana providing essential in-country knowledge and influence with important stakeholders and ICPCN providing expertise on children’s palliative care. With GHP being a UK government funding body, one key priority for them was bi-directional learning between the UK and Ghana and so we also worked with the Association of Paediatric Palliative Medicine (the national body for CPC doctors, nurses and pharmacists in the UK) to deliver the programme.
The project built on the needs assessment and situational analysis carried out in the previous year, which identified that there were at least 137,380 children in Ghana in need of palliative care and 7,576 child deaths per year. With only one dedicated children’s palliative care doctor for the whole country, the need for children’s palliative care development was huge. The needs assessment identified that one of the fundamental pillars to address this gap was to provide a programme of education and training. The opportunity to apply for funding from THET arose, the bid was successful and #ChilPalCare Ghana was born!
The project aimed to raise awareness of children’s palliative care and provide training so that participants could take the learning back to their institutions and seed the development of a children’s palliative care team. There were four main elements to the project:
Webinars: we held ten webinars over the course of the year on a range of topics from neonatal palliative care, pain and symptom management to looking after yourself and the team. These were delivered by a member of the APPM in partnership with a professional from Ghana to provide a case study and local Ghanaian context to the sessions. We had initially aimed to reach 200 health professionals. We were amazed that in total we had over 2,150 individuals registering and 1,597 attending the sessions live with many more watching the recordings.
Dr Emily Harrop and Mark Azongo having fun in the snow at Helen and Douglas House
Face-to-face training: we held four week-long face-to-face training sessions in different regions of Ghana and provided training to 127 professionals. The sessions were led by Alex Daniels and Professor Julia Downing from ICPCN, a representative from APPM and local experts. We invited two participants from over 60 facilities across all regions of the country. Each participant was tasked with developing an action plan to take back to their institution and we provided an opportunity for mentoring to support the implementation of these plans. All of those who responded to the evaluation survey said they plan to continue cascading the education to their colleagues and supporting the development of a children’s palliative care team in their respective facilities. The level of engagement and enthusiasm was extremely high and many participants fed back the difference the training has made to them.
“I can say this has made me a better nurse, a better version of myself, …every platform I stand, or even if I appear to give care, I believe that I am more confident, I stand tall among my peers.”
One of the UK faculty, Dr Emily Harrop, Medical Director of Helen and Douglas House, shared a blog of her reflection on her time in Ghana.
Clinical placements: We were able to provide a two-week clinical placement for half of the training attendees (60 in total) at either Korle-Bu or Komfo-Anokye Teaching Hospital,. We also funded 6 people to travel to the UK for a placement – 2 each from the Ghana College of Physicians and Surgeons, the Ghana Colleges of Nurses and Midwives and the Ghana College of Pharmacists. These participants were also able to attend the APPM Conference which was a great addition to their learning experience.
Strategic development: As a short-term project we wanted to build in a sustainability plan by working with the Ghanaian Colleges to support them to develop children’s palliative care curricula. We held a high-level meeting with the College representatives and are pleased to report that they have already developed plans to embed these into their programmes. In addition, we nurtured partnerships with the Ghana Palliative Care Association (GPCA), to ensure inclusion of children in their new palliative care strategy which is currently with the Ghanaian Ministry of Health.
Celebrating the end of the project
Over 200 delegates at the final celebration event in Accra
As the project reached its conclusion we held a celebration event in Accra, attended by over 200 participants and dignitaries from the Ministry of Health, the Colleges, the GPCA and other national bodies. There was extensive media coverage, with footage shown on three Ghanaian TV channels. You can watch a video of our colleagues from Ghana talking about the project.
https://vimeo.com/1060133025/3789a8c6b5
Evaluation
We commissioned an external evaluation which has been carried out by Dr Eve Namisango from APCA, Professor Lydia Aziato and Eric Tornu from the University of Health and Allied Sciences and Eric Tornu from the University of Ghana. They have submitted a report and a draft learning paper from the project which we look forward to sharing in the coming months.
What’s next?
As we wrap up this phase of our work in Ghana we are looking forward to the next. We are delighted to have secured additional funding, with which we plan to continue the webinars, training and, importantly, to further integrate children’s palliative care training into the Colleges with the development and delivery of a Training of Trainer programme. We also hope to build a learning hub within Ghana from which to spread the training opportunities to other countries in West Africa.
Thank You’s
There are so many people to thank, but in particular ICPCN and WCC would like to thank:
- Dr Barbara Ossei Sekyere, Dr Nihad Salifu, Dr Joyce Bening, Dr Ernestina Schandorf, Dr Gladys Dzansi, Dr Kofi, Dr Abena Foriwaa Sarpong, who gave so generously of their time to deliver training and provide clinical placements;
- members of the APPM (Dr AK Anderson, Dr Emma Gates, Dr Hannah Linford and Dr Emily Harrop) for giving their time to travel to Ghana and share their expertise; and the
- institutions in the UK who hosted clinical placements: Shooting Star Children’s Hospice, Helen and Douglas House, All Wales Managed Clinical Network, Alder Hey Children’s Hospital and Evelina Children’s Hospital.
- All of our partners who have made this project possible, including but not limited to: Ministry of Health Ghana, Ghana Health Services, Korle-Bu Teaching Hospital, Komfo-Anokye Teaching Hospital, Ghana College of Physicians and Surgeons, Ghana College of Nurses and Midwives, Ghana College of Pharmacists, Ghana Palliative Care Association, Association for Paediatric Palliative Medicine, The African Palliative Care Association, St Jude Global Palliative Care, Stanford University Division of Quality of Life and Pediatric Palliative Care, Global Health Partnerships along with the wider stakeholders including COMPASS Ghana, Lifeline for Childhood Cancer Ghana, Ghana Psychological Council, The Childhood Cancer Society of Ghana, University of Health and Allied Services, the University of Ghana and the Global Initiative for Childhood Cancer.
Funding
This project was funded by the UK Department of Health and Social Care (DHSC) and managed by Global Health Partnerships (GHP) formerly the Tropical Health and Education Trust (THET) as part of the Global Health Workforce Programme (GHWP).