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Our Integration Approach

Our Approach - APCA Integration
Health Systems Strengthening

Our Approach

A comprehensive, evidence-based methodology anchored in the WHO Health Systems Framework, integrating palliative care across service delivery, workforce development, essential medicines, and community engagement to achieve Universal Health Coverage.

Since 2004, APCA has implemented three strategic plans to integrate palliative and comprehensive chronic care into national health systems across Africa. Our approach recognizes that palliative care is both a health system function and a societal responsibility, requiring simultaneous action across multiple levels—from community health workers to Ministries of Health.

WHO Building Blocks Framework

Our integration strategy adheres to the WHO's six health system building blocks, ensuring comprehensive system strengthening rather than isolated interventions. We work across all pillars simultaneously to create sustainable, scalable change.

🏥 Service Delivery

Integrating palliative care into primary, secondary, and tertiary facilities. Supporting 295+ service providers across 35 countries through small grants, referral networks, and quality standards implementation.

👩‍⚕️ Health Workforce

Supporting 31+ academic institutions to integrate PC curricula. Training 4,000+ care providers through scholarships and pre-service education, including specialized training in grief counseling and paediatric care.

📊 Health Information

Piloting digital health technologies including the Mpalliative app for remote symptom monitoring. Integrating PC indicators into national HMIS systems to track coverage and quality.

💊 Medical Products

Supporting 7 countries to establish local oral morphine reconstitution facilities. Training 550+ legal prescribers in opioid analgesics and advocating for balanced access to controlled medicines for medical use.

💰 Financing

Advocating for domestic financing and UHC inclusion. Supporting National Palliative Care Associations to engage in health financing dialogues and developing sustainable hybrid funding models.

🏛️ Leadership & Governance

Supporting 10+ countries to develop standalone national PC policies. Convening African Ministers of Health sessions to advance policy commitments and WHA Resolution 67.19 implementation.

Multi-Level Integration Model

Community & Home-Based Care

We strengthen the foundation of care by training village health teams, community volunteers, and family caregivers. Our community-based models bridge formal health services with household support, ensuring continuity of care for patients who cannot reach facilities.

  • Grief & Bereavement: Co-designed intervention training 181 community lay grief counsellors in Uganda, reaching 180 bereaved households with culturally appropriate psychosocial support
  • Prevention Integration: Reaching 2,076 vulnerable girls with HPV vaccination through palliative care providers' community networks
  • Last Mile Access: Conducting 7,106 home visits annually through small grants support to reach bedridden patients
🏘️

Community Anchored

Bridging facility-based care with home support

1,873 Adult patients receiving palliative care through community-based programmes
🏥

Clinical Excellence

Person-centred care in hospitals and hospices

77 Patients reached with CALM (Managing Cancer and Living Meaningfully) person-centred end-of-life care sessions

Facility-Based Integration

We embed palliative care within existing health facilities, from rural health centers to national referral hospitals, ensuring patients receive holistic care regardless of their disease condition or stage of illness.

  • Person-Centred Outcomes: Implementing the APCA Children's Palliative Care Outcome Scale (C-POS) to drive quality improvement through direct patient feedback—used in over 2,000 clinical assessments to enhance communication and symptom management
  • Legal Integration: Embedding legal aid services into clinical care to address patient rights, inheritance issues, and access to entitlements
  • Disease-Specific Programs: Integrating PC into oncology, HIV/AIDS, cardiovascular, and NCD departments to ensure seamless referral and continuity

Digital Health Innovation

Leveraging technology to overcome geographical barriers and improve real-time communication between patients, caregivers, and clinicians. Our digital solutions enhance remote monitoring, education, and supply chain management.

  • Mpalliative App: Mobile platform enabling patients to self-report symptoms from home, transmitting data instantly to clinician dashboards for timely intervention
  • Virtual Conferences: Hosting triennial African Palliative Care Conferences and webinars to reduce costs while reaching pan-African and international audiences
  • Digital Repository: Maintaining online access to training materials, webinar recordings, and the APCA Atlas in multiple languages
📱

Technology-Enabled Care

Remote monitoring and teleconsultation

90% Of users found the Mpalliative platform easy to use for reporting symptoms in their preferred place of care

Research Informing Integration

We utilize operational research and outcome measurement as tools to strengthen integration efforts. By generating evidence on effective models of care—such as the impact of peer advocacy on cervical cancer screening or community grief interventions—we inform policy decisions and refine service delivery to ensure interventions are context-appropriate and effective.

Key Implementation Strategies

01

Education & Capacity Building

Integrating palliative care into pre-service and in-service training for doctors, nurses, clinical officers, and allied health professionals. Supporting 87 health workers through scholarships to enhance specialized skills.

02

Policy & Advocacy

Supporting Ministries of Health to develop national PC policies and implement WHA Resolution 67.19. Facilitating African Ministers of Health sessions to secure high-level commitments for UHC integration.

03

Service Delivery Grants

Administering True Colours Trust Small Grants to 20+ palliative care providers annually across 12 countries, supporting home-based care, psychosocial support, and essential medicines access.

04

Cancer Prevention Integration

Pioneering the integration of cervical cancer prevention into palliative care through the "Game Changers" initiative—training women with lived experience to advocate for screening within their social networks, achieving 63.8% screening uptake among previously unscreened women.

05

Essential Medicines Access

Supporting local oral morphine production in 7 countries and training 550+ prescribers. Advocating for balanced drug policies that ensure access to controlled medicines while preventing diversion.

06

Cross-Border Collaboration

Facilitating experiential visits and twinning arrangements between African countries to share best practices. Supporting national palliative care associations in 8 countries to strengthen local ownership.

"Our approach recognizes that palliative care is both a health system function and a societal responsibility. We combine clinical excellence with community compassion, ensuring that dignity, equity, and access remain at the center of all integration efforts—from the community health worker to the Minister of Health."
— APCA Strategic Framework 2020-2030

Institutionalizing Integration

True integration requires embedding palliative care permanently within national health infrastructure rather than relying on parallel donor-funded projects. We support Ministries of Health to include palliative care in national budgets and UHC benefit packages, strengthen National Palliative Care Associations to lead local integration efforts, and transition services from external funding to domestic financing—ensuring palliative care remains a sustainable, essential component of African health systems for generations to come.