Edinburgh Napier University

  Background: Palliative care should be a component of COVID-19 management to relieve suffering, improve patient outcomes and save costs.
Aims: We aimed to identify and appraise palliative care recommendations within COVID-19 management guidelines in all African countries.
Methods: We systematically searched and identified official national treatment and care management guidelines for COVID-19 published between December 2019 and May 2020, irrespective of the language of publication. We included only guidelines prepared by the ministry of health or other government-designated body in each country. We developed a matrix based on the African Palliative Care Association (APCA) standards for providing quality palliative care and conducted a rapid document analysis of the content of the guidelines against these standards. We graded the COVID-19 case management guidelines on how they meet the quality standard as either fully met, partially met, not met, or not applicable.
Results: Fifty-five documents were retrieved from 29 out of 54 African countries. Fifteen documents (11 in English and four in French) from 15 countries met the inclusion criteria. Of these, eight countries included specific palliative care recommendations in their COVID-19 management guidelines. The other seven countries have statements of recommendations which were relevant to palliative care. Only standard 2.5 (Management of opportunistic infections) of the APCA palliative care standards was fully met by 14 out of 15 guidelines. Standards 2.1 (Planning and coordination of care), 2.2 (Access to Specialist Palliative care), 2.4 (Pain and symptom Management), 2.6 (Management of Medications), 2.11 (Care for special needs populations), and 2.17 (Providing support to care providers) were partially met by the majority of the guidelines. The majority of the standards were not met.
Conclusion / Discussion: Governments and policymakers in Africa must prioritise quality palliative care within COVID-19 case management guidelines to ensure access and improved patient outcomes.