Global Health Academy

Evaluation of Three Palliative Care Programmes

Caring for the dying is a critical part of health systems.

When many health systems in low income countries are already struggling to deliver curative and preventive care can we really prioritise palliative care?

Is it more important to care for the living and those starting life, than to care for those coming to the end of their lives?

These are difficult questions, with difficult answers.

We argue that caring for the dying is not optional, but a critical part of health systems. Perhaps the way a society care for their dying reflects how well a society cares for their living.

Death and dying

In Todd May's book  called 'Death', May argues that the fact that we die is the ‘single most important thing about us’. He sees death as central to life, and he believes those who reject its centrality are denying the power of life as well as the power of death.

Our own health systems have been death denying, which has made them much poorer than they might be. We can learn lessons form other health systems, particularly systems in low income countries, where communities capacity to talk about death is so much greater than ours.

We know that the one thing we all share, regardless of who we are and where we live, is the fact that we die. What we don’t share is the opportunity for a ‘good death’.

Tragically those who die from chronic diseases, especially in many low income countries, are probably going to die in more pain. The journey towards death will probably be over a much longer period, and the cost of dying and death from a chronic disease may be the factor that pushes families into an unbearable cycle of poverty.

Programmes in Kenya, Malawi and Uganda

These evaluations of programmes outline some of the issues that palliative care programmes are facing. They also show some of the amazing work that teams carry out with almost no resources.


This project was funded by the Palliative Care Initiative (PCI) of The Diana, Princess of Wales Memorial Fund.