Assessment of Palliative Care Approach to HIV/AIDS Clients and Their Family Care Givers, Tigray Region

Abstract

Background: Palliative care in the context of HIV is a broad and new concept which begins with the HIVpositive diagnosis and extends through the end of life. The goal of palliative care is improving quality of life of PWHA and their family care givers. Palliative care approaches involves five components; clinical, psychological, targeted preventive therapies, social and spiritual care. In Ethiopia Palliative Care at programmatic care level is introduced in the existing HIV care services very recently. TRHB, in collaboration with I-TECH Ethiopia initiated Palliative Care within the existing HIV care services since 2006 GC. Findings of this study will help in standardizing and scale up of the existing Palliative care service provision Objective: is to assess the current health facility based Palliative Care approaches for PWHA and their family caregivers in 12 ART/ Palliative Care providing hospitals in Tigray region. Methods: A cross - sectional descriptive study conducted between the periods from April, 2008 – June, 2009. Clinical records of 384 adult PWHA in HIV care reviewed, 387 clinician’s perception of palliative care measured using Likert scale and availability of basic palliative care supply assessed. Result: Findings indicated that underlying causes of symptoms treated for 60-82.9% of clients with fever, weight loss or wasting, chronic fatigue, GI symptoms, and cough. Pain prevalence was 15.1% and 40(69%) received pharmacologic management. Few clients developed drug toxicities and one third up to 100 % treated. Laboratory and clinical monitoring was done for 80 -98.7% of clients. CPT, Wuha Agar and condom were provided for 80%, 56.5% and 54.2% of the clients, respectively. Partner 42(10.9%) and children 26(5%) tested for HIV. Psychosocial support provision was very poor. The spiritual care provision was also alarmingly undervalued. About two third (65.4%) of clinicians had poor perceptions of palliative care. Conclusion and Recommendation: Generally there is a promising ground to strengthen and scale up palliative care services at national level. Individual HIV clinical record review, uninterrupted palliative care supplies, training of more clinicians on palliative care, strengthening care coordination between hospital, community and home based palliative care services and developing National Palliative Care Guideline considering care for care givers is recommended.