Advocates demand dignity in care of palliative patients

Consultant Gynecologist Oncologist and Obstetrician Dr Anisa Mburu briefs the media on the sidelines of a three-day workshop on palliative care services

A new push seeks to embed sexual and reproductive health services into palliative care to ensure patients receive complete, dignified treatment.

Kenya Hospices and Palliative Care Association (KEHPCA) executive director David Musyoki stressed the urgency of making reproductive health services accessible to patients receiving palliative care.

He spoke in Mombasa during the launch of a new Sexual and Reproductive Health (SRH) toolkit.  

The toolkit, which aligns with the National Palliative Care Policy, is designed to equip healthcare providers with practical guidance on delivering SRH services with sensitivity, respect, and in line with legal and ethical standards.

It also aims to serve as a reference for healthcare professionals, policymakers and advocates working towards a more inclusive, patient-centred healthcare system.

Despite notable strides in palliative care, Musyoki said services remain limited, with only 124 health facilities, largely concentrated in major towns, currently offering palliative care.

“These are sites serving close to 50 million people. Of course, not everyone is affected, but we still have counties and areas where palliative care has not yet been integrated,” Musyoki said, noting rural communities are particularly underserved.

He urged government and other health stakeholders to prioritise equitable access to integrated and comprehensive palliative care services in urban and rural settings.

Musyoki emphasised that sexual and reproductive health concerns are common among patients facing life-threatening illnesses and should not be overlooked in care planning.

“These include conditions that are difficult to cure, such as advanced organ diseases, cancers, cardiovascular diseases and other complex illnesses," he said.

"Patients with such conditions require holistic care and support, and reproductive health is a critical component of that care.” 

To bridge the workforce gap, KEHPCA is advocating expanded training of healthcare workers in palliative care, in addition to strengthening ongoing on-the-job training programmes.

The association further urged the full integration of palliative care into Taifa Care under the Social Health Authority (SHA), pointing out that current coverage largely focuses on inpatients while leaving out many outpatients.

“Many patients with life-threatening conditions may not require admission per se. They need care and support while in the comfort of their homes. Home-based care, which falls under primary healthcare, is therefore a significant need,” Musyoki said.

Dr Anisa Mburu, a consultant gynaecologic oncologist and obstetrician-gynaecologist, said 69 per cent of Kenyan adults require some form of palliative care due to non-communicable diseases.

“The most important issue is that sexual and reproductive health has not been addressed as adequately as it should,” she said.

Mburu said the newly launched toolkit will enable healthcare workers and patients to better understand SRH and encourage open dialogue, even in the face of cultural sensitivities surrounding sexual matters.

Laikipia Palliative Care Centre manager Edwin Gitonga appealed to county governments to offer palliative care services free of charge and called on the SHA to expand coverage to outpatients to ease the financial strain, particularly for cancer patients.

“Cancer is financially, psychologically and physically draining. When patients receive adequate support, it significantly improves their quality of life," he said.

"Palliative care begins at diagnosis and continues through to end-of-life care. It is time we dispel the misconception that palliative care only starts at stage four.”

Gitonga also highlighted ongoing challenges in accessing essential pain relief medication, especially morphine.

“We are facing a serious crisis in accessing morphine,” he said.