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• W4200235108 abstract "<h3>Background</h3> Paediatric palliative care services in LMIC countries compete for resources with many other priorities. Their provision is desirable and includes advocacy, training health and community care workers, policy development and mentorship. <h3>Objectives</h3> The THET J&J start-up grants provided an ideal opportunity to establish a partnership with the Ministry of Health (MoH). The long term aim being to develop children’s palliative care services in The Gambia. A needs assessment was carried out in early 2020. We hope reporting the results raises awareness of the gaps and possible solution <h3>Methods</h3> The study took the form of a cross-sectional design with a focus on estimating the need for CPC and gaps at the country level. A mixed methods approach utilising both quantitative and qualitative data was used. Both primary and secondary data sources were used. The estimation of the need for CPC was based on estimation techniques using the prevalence and mortality of the specific diseases known to require palliative care. The response to the need and existing gaps were analysed using interviews and focus groups with key persons as well as survey data from service providers. Ethical approval for this study was given by the University of the Gambia, School of Medicine. Reference number R020 004 <h3>Results</h3> Five organisations completed a Capacity Self-Assessment Tool, 17 staff from 5 facilities were interviewed and 2 Focus Group Discussions conducted (8 staff). The leading cause of death in children was heart disease, then lower respiratory infections and neonatal disorders, with HIV/AIDS being 5th, Tuberculosis 7th and cancer 9th. Under 5 mortality is 47.8 per 1,000 live births. It was not possible to estimate prevalence. Facility capacity assessment to provide CPC ranged from 23%-74%. Themes identified were a need to improve diagnostic ability; a desire for training; improve access and utilisation of medicines; and provide support for families. Training in Palliative care is on the nursing and medical students syllabus. Senior staff were keen for more training. Topics that staff felt anxious about were breaking bad news, anticipating palliative needs and use of medication. <h3>Conclusions</h3> The establishment of a training and mentoring service for staff in palliative care is required and desired. Paediatric diagnostic facilities need improved including equipment and access to specialist opinions eg an echocardiogram. in the main hospital in Banjul. The use of online Palliative training through lectures and modules, supported by scheduled in person visits is thought to be a good solution particularly in the current Covid-19 situation. 1 online lecture session has already taken place for 30 participants, supported by the MoH. This had good media coverage and promoted CPC awareness within the country. M.Sowe is currently undertaking a Palliative Care Diploma in Uganda partly funded by this grant. The World Bank has recently provided funding for specialist paediatrician secondment to The Gambia to improve paediatric services and a memorandum of understanding for patient pathways has been signed with the much larger neighbouring country of Senegal." @default.
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• W4200235108 date "2021-09-30" @default.
• W4200235108 modified "2023-09-25" @default.
• W4200235108 title "914 Development of a partnership to improve palliative care services for children in the Gambia" @default.
• W4200235108 doi "https://doi.org/10.1136/archdischild-2021-rcpch.278" @default.
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