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1
Zambia is facing a severe economic crisis marked by high inflation, increasing poverty and a heavy debt burden that is straining both its fiscal stability and progress in health outcomes. By 2020, the country's external debt reached United States dollars (USD) 12.7 billion, representing 108% of the
...
country's gross domestic product (GDP). In 2020, Zambia sought assistance through the G20 Common Framework and the International Monetary Fund (IMF) Extended Credit Facility (ECF), securing a USD 1.7 billion loan over 5 years. IMF loans, however, come with austerity measures that prioritise fiscal discipline but could potentially exacerbate social inequalities. These measures, which include increasing consumer taxes on goods and services (value added taxes - VATs), electricity tariffs and fuel prices, disproportionately impact vulnerable populations, raising concerns about their long-term effects on essential services, especially accessible and good quality healthcare services.
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The 2024 World Malaria Report shows that the malaria burden remains overwhelmingly concentrated in Africa. The continent accounted for 94% of global cases and 95% of malaria-related deaths in 2023. Although the number of malaria cases increased globally from 204 million in 2000 to 246 million in 202
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3, the number of deaths declined from 805,000 to 569,000. Children under five are still the most affected group, accounting for 76% of malaria deaths in Africa. A few countries, particularly Nigeria and the Democratic Republic of the Congo, carry the highest burden. Since 2000, Africa has significantly reduced malaria incidence and mortality, averting over 1.7 billion cases and 12 million deaths. Nevertheless, malaria continues to pose a significant health challenge, necessitating ongoing action and investment.
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To guide the provision of quality palliative care services across the African region, the African Palliative Care Association (APCA) has developed a framework of core palliative care competencies that can be used by service providers, educators and other stakeholders to guide programmes development.
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These guidelines have been developed in simple, user-friendly language and they explain the procedures for patients’ access to and the safe management of Schedule I and II drugs that are necessary for the treatment and relief of moderate to severe pain. They provide both procedures for acquisition
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and information on records or documents that are necessary to ensure that these medicines are made available and accessible to patients across the entire health care delivery system (i.e. from tertiary institutions to primary level) and ensuring prevention of illicit non-medical use.
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This resulting toolkit is a practical guide intended to assist users to become advocates for palliative care in a practical and effective
way. It is not necessarily a resource to read from cover to cover; rather, it can also be used selectively to each reader’s needs to engage audiences and
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ensure that there is a real understanding of the need for palliative care. It should also be read in conjunction with the supplementary resources listed at the end of each of the toolkit’s sections.
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The Guidelines for the Use of the APCA African Palliative Outcome Scale (POS) has been developed by the APCA, in collaboration with
stakeholders, to help appropriately trained health practitioners and researchers across the region to utilise the APCA African POS in their work place (Powell et
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al, 2007; Warria et al, 2007). Not only do the guidelines provide a clear rationale for measuring palliative care outcomes, but they also outline practical information on how to use the tool to collect data and analyse its results. So why is there a need for these guidelines?
Palliative care as a concept and discipline is not well understood across Africa, and its development is still embryonic in many countries. While there are many obstacles that hinder palliative care development on the continent, a key challenge is the lack of accurate information about the palliative care being provided and its outcomes. The APCA African POS is a useful tool to help us measure these outcomes and, given that
measuring palliative care outcomes remains a relatively new concept, it is important to guide people on how to use the tool. Of course, these guidelines are not intended to address everything related to the measurement of palliative care outcomes; they contain only essential information for providers. More detailed information on the use of outcome tools, and in particular within the research setting, can be gained from contacting relevantly trained professionals.
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In the absence of a such a measure, and building on the success of developing the APCA African
Palliative Outcome Scale (POS) for adults, the African Palliative Care Association has developed the
APCA African Children’s POS. The tool has been validated across diseases, countries, settings and
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languages and used in both quality improvement and research studies. Moreover, feedback on the
tool from doctors and nurses who have used it has been very supportive, with providers perceiving
it as an easy-to-use instrument that helps them undertake holistic assessments that in part entail
discussing difficult issues.
This booklet is a practical guide intended to help users employ the APCA African POS correctly.
Following a discussion of the origins and background to the APCA African PPOS, the guide discusses
the measurement of outcomes, the development of the tool and its use (including the analysis of
collected data), before finishing with illustrative examples of the use of the questionnaire.
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In this guide, the African Palliative Care Association (APCA) has put together evidence‑based information on the use of specific opioids commonly used in the management of moderate‑to‑severe pain to manage both cancer and non‑cancer pain. APCA hopes that this guide will be a useful tool i
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n aiding health professionals at all levels of healthcare delivery to assess and manage pain using opioids. All opioids included in this guide are listed on the WHO model list of essential medicines but we remind readers that oral morphine is the standard opioid of choice for managing moderate‑to‑severe pain and we recommend that it should be made available at all times.
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During the reporting period, significant progress was made in strengthening the mpox response across the continent. The lessons learned and challenges identified during the joint mpox continental intra-action review (IAR), which took place successfully in December 2024 in Addis Ababa have guided the
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development of the action plan for the response to the mpox epidemic in January and February 2025.
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Communicable Diseases Control in Emergencies
recommended
A field manual
Early-warning indicators to prevent stock-outs and overstocking of antiretroviral, antituberculosis and antimalaria medicines.
Case Management; Guide for Tutors
A guide to facilitating community-managed disaster risk reduction in the Horn of Africa.
This manual describes how to help communities implement disaster risk reduction activities. It was written for development workers and community-based organizations in the Horn of Africa, but practitioners can
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use it to implement activities around the world
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Guiding Principles for Feeding Infants and Young Children During Emergencies
recommended
WHO
(2004)
A Joint Statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children’s Fund
