Pediatric Palliative Care in Zimbabwe

Abstract

Economic adversity during the last decade has eroded earlier positive developments in pediatric palliative care in Zimbabwe. A dire shortage of skilled palliative care practitioners coupled with increasing demands on health services to manage the problems associated with a high prevalence of HIV/AIDS have resulted in the burden of care being carried mostly by the community and family, and a handful of organisations practising palliative care. Home based care organisations using volunteer community caregivers are increasingly expected to provide elements of palliative care, having received only basic training. The advent of anti retroviral therapy (ART) has significantly extended quality and length of life for many and has special relevance for children living with HIV. However, for those who are unable to access this treatment, and for many who are on treatment, the need for pediatric palliative care remains important for the relief of suffering. Avoidance of talking to children about living with a life limiting illness continues and is perhaps exacerbated by a focus on living positively in the era of ART. Palliative care services for children struggle to provide the full range of holistic care citing problems of time, privacy and a limited multi disciplinary approach due to a shortage of relevant professionals and a lack of co-ordination. The potential for scaling up pediatric palliative care in Zimbabwe is enormous but will depend largely on human resource capacity.