Empowering African professionals to assess palliative care development: regional application of the WHO framework.
Fernanda Bastos, Vilma A Tripodoro, Alvaro Montero, Ana Cristina Béjar, Eduardo Garralda, Virginia Gathoni Gichuru, Anthelme Kouessi Agbodande, Eve Namisango, Emmanuel Luyirika, Carlos Centeno
Abstract
Open AccessINTRODUCTION: The WHO has proposed a structured framework to assess palliative care development through 14 actionable indicators across 6 dimensions. While prior applications have been limited to individual countries, this study explores the feasibility of empowering professionals across an entire region to independently evaluate palliative care development using the WHO framework. METHODS: An expert-informed, participatory implementation study was conducted across the African continent. A structured survey based on the WHO indicators was developed and translated into multiple languages. A regional network of national consultants was established, and participants were trained through an asynchronous, tutored online course. Data collection involved self-assessment of national palliative care development, accompanied by narrative justifications and documentary evidence. Validation processes included peer review and, where feasible, endorsement by national associations or authorities. Empowerment was assessed through course completion, perceived impact via post-course surveys and participation in data validation. RESULTS: National-level data from 50 African countries were included, based on 121 contributors. Most countries had at least two contributors, ensuring data triangulation. Validation processes were completed in 48 countries, with 21 reports endorsed by national associations or authorities. Post-course surveys indicated that 91% of respondents rated the course highly for professional value, and 95% expressed interest in ongoing collaboration. The data collected are already informing global comparative analyses, including the African Palliative Care Atlas (2025 edition). CONCLUSIONS: This study demonstrates that with appropriate training and support, professionals across an entire region can independently assess palliative care development using the WHO framework. The approach fosters professional empowerment and provides high-quality, context-rich data, laying the groundwork for similar initiatives in other regions and contributing to a coordinated global assessment of palliative care development.