What is Integration?
Embedding palliative care into the fabric of health systems—transforming it from an isolated service for the few into an essential component of care for the many.
A Continent in Need
While palliative care is recognized globally as a human right and essential health service, Africa faces the world's most severe access crisis. The gap between those who suffer and those who receive relief is staggering.
Beyond End-of-Life Care
Integration is the strategic incorporation of palliative and comprehensive chronic care into national health systems at all levels. It transforms palliative care from a narrow, end-of-life intervention into a holistic approach that accompanies patients from diagnosis through the entire continuum of care.
Working Definition
"Integration ensures palliative care is understood and embedded as an essential component of Universal Health Coverage—providing pain relief, symptom management, and psychosocial support alongside curative treatments, from the moment of diagnosis until recovery or death, without exposing users to financial hardship."
Why Integration Matters Now
Universal Health Coverage
The UN Sustainable Development Goals and UHC 2030 recognize palliative care as an essential health service. Integration ensures these services are included in national benefit packages without financial hardship, fulfilling the promise of "health for all" and "leaving no one behind."
The Continuum of Care
Integration embeds palliative care across the full spectrum: from health promotion and disease prevention, through early detection, diagnosis, and curative treatment, to rehabilitation and long-term chronic care. It is not an alternative to curative care—it complements it.
Comprehensive Chronic Care
For patients with long-term conditions—whether cancer, HIV, heart failure, or chronic respiratory disease—integration ensures access to wide-ranging services along the continuum. It addresses the reality that many Africans live with life-limiting illnesses for months or years, not just days.
Total Pain Approach
True integration recognizes that suffering is multidimensional. It bridges clinical care with psychosocial support, spiritual care, legal services, and family caregiving—addressing physical, emotional, social, and spiritual distress in culturally sensitive ways.
The African Context
Africa's unique disease burden and health system realities demand an integrated approach that acknowledges both the scale of need and the resource constraints.
Dual Disease Burden
High prevalence of both communicable diseases (HIV, TB, COVID-19, Ebola) and rising non-communicable diseases (cancer, cardiovascular, diabetes), each generating immense palliative care need.
Humanitarian Situations
Large displaced populations in refugee camps require palliative care in emergency settings. Integration ensures continuity of care during crises and displacement.
Pediatric Crisis
Children account for >30% of deaths associated with serious health-related suffering in LMICs vs. <1% in high-income countries. Integration ensures pediatric palliative care is not an afterthought.
Financial Protection
Current out-of-pocket payment for palliative care impoverishes families. Integration into UHC eliminates user fees at the point of care, protecting vulnerable households from catastrophic health expenditure.
From Isolation to Integration
Integration transforms palliative care from an isolated, under-resourced service for the privileged few into a fundamental component of health systems that reaches the 9.7 million Africans currently suffering without support. It is the bridge between the world as it is and the world as it should be.