Educators at the Hospice Africa Uganda Institute have urged the Ministry of Health to ensure proper deployment of palliative care nurses in health centers to enhance the delivery of this critical service.
Dr. Ekiria Kikule, the principal of Hospice Africa Uganda, made the appeal during the graduation ceremony for Master’s and Bachelor’s degree students in palliative care from Makerere University.
Dr. Ekiria highlighted that many trained palliative care nurses, upon completing their training, are often reassigned to unrelated departments such as theater or outpatient services rather than palliative care. This misallocation significantly impairs the delivery of palliative care in health facilities.
She emphasized the importance of assigning these nurses to palliative care roles, noting that the Ministry of Health had developed a policy to integrate palliative care services starting from Health Center IIIs and IVs. However, the policy has yet to be fully implemented. “We cannot train nurses in palliative care and then deploy them elsewhere,” she stated.
Dr. Ekiria also stressed that many of these nurses are trained to prescribe oral liquid morphine for pain relief and managing other distressing symptoms. She expressed concern that oral morphine often expires in health centers due to the lack of trained prescribers, leaving patients without access to necessary care.
She called for the recognition of palliative care nursing as a specialized profession, urging the creation of appropriate positions within the healthcare system.
Dr. Ekiria added that Hospice Africa Uganda is working with the Uganda Nursing and Midwifery Council, the Ministry of Health, and other stakeholders to have palliative care officially recognized as a specialty.
Joyce Zalwango, the Capacity Building Manager at the Palliative Care Association of Uganda (PCAU), emphasized the need for more healthcare workers trained in palliative care to meet the growing demand for this service across the country.
She encouraged graduates, particularly those with Master’s degrees, to advocate for palliative care by engaging with policymakers, describing it as a vital service for Uganda.
Agnes Baku Chandia, the Commissioner for the Nursing and Midwifery Department at the Ministry of Health, commended the Institute for advancing its educational offerings from diploma to master’s levels, which she believes will strengthen advocacy for palliative care. She encouraged graduates to be innovative in delivering palliative care, even in resource-constrained settings.
Chandia noted that deployment challenges are not unique to palliative care but also affect other specialties, including critical care. She revealed that the Ministry of Health plans to address this issue by requesting a directive from the Permanent Secretary to ensure specialists remain in their trained fields.
A total of 33 healthcare professionals from Uganda, Kenya, Malawi, Tanzania, Swaziland, Cameroon, and Zambia received degrees, including 17 Master’s and 16 Bachelor’s graduates. Eight graduates, seven Master’s and one Bachelor’s, were supported by scholarships from the Irish Hospice Foundation.
Other students received funding from Build Community Give Care (BCGC), PCAU, and the African Palliative Care Association (APCA).
Prossy Nakyanja, Executive Director of Hospice Africa Uganda, underscored the importance of training healthcare workers across Africa, emphasizing that education is key to embedding palliative care into healthcare systems.