An evaluation of a palliative care outreach programme for children with Burkitt lymphoma in rural Cameroon

Background: Palliative care (PC) is the most appropriate treatment for patients with life-limiting, incurable diseases, but it is a relatively new concept in sub-Saharan Africa (SSA). A lack of curative treatment options for some conditions creates a great need for PC, but such services are rarely provided in SSA. More research into PC in SSA is urgently needed to create an evidence base to confirm the importance of appropriate PC services. Objectives: To gain a better understanding of the needs of patients and their families visited by a children's PC nurse in Cameroon and to identify aspects of the service that can be improved. Methodology: A qualitative study design with semi-structured interviews was used. Tape-recorded interviews were transcribed and thematically analysed. Results: Twelve interviews were conducted with patients, carers and nurses. Financial aid, general disease improvement and prayers were the directly expressed needs of service recipients. Specialist training in children's PC was the main need expressed by the nurses. Open communication about clinical status and treatment failure, more detailed counselling, more distraction for patients and respite for carers were identified as underlying needs. Conclusion: It is possible to provide an effective children's PC service that meets the most urgent needs of recipients in a rural setting in SSA. Recommendations include improved counselling, specialist education for staff, expansion of local support networks and more frequent home visits. More studies are needed to help define the need for PC in children with life-limiting diseases.