Dataset Information

Building an action plan to tackle palliative care inequality through multi-stakeholder platforms.

ABSTRACT:

Background

To achieve universal care and overcome existing barriers, the most effective strategy is to devise an action plan that incorporates palliative care into primary health care (PHC), as recommended by the World Health Organization's (WHO) Astana Declaration. In Colombia, a country with an upper-middle-income status, about 128,000 individuals experience severe health-related suffering (SHS) that necessitates palliative care. Although the country's healthcare system has made steady strides in the integration and development of palliative care, there is still no national plan in place for palliative care.

Objective

Build up Colombia's palliative care plan through stakeholder consensus.

Method

Based on the participatory action research method and the multi-stakeholder platforms model, this study convened 142 stakeholders from different levels of the health system (patient representatives, journalists, health professionals, government entities, insurance companies, universities, and drug regulatory authorities).

Results

The national plan aims to achieve its objectives through a series of strategic actions. These include integrating and diversifying palliative care services, improving access to opioids, increasing palliative care education, promoting community-based palliative care programs, securing funding, and implementing a regulatory framework for palliative care by public policymakers.

Conclusions

The national palliative care is an alliance that aims to reduce palliative care inequity in Colombia by 2026 by empowering stakeholders nationwide to collaborate around specific goals and objectives.

SUBMITTER: Sanchez-Cardenas MA

PROVIDER: S-EPMC10424546 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Building an action plan to tackle palliative care inequality through multi-stakeholder platforms.

Sánchez-Cárdenas Miguel Antonio MA León-Delgado Marta Ximena MX Rodríguez-Campos Luisa Fernanda LF Correa-Morales Juan Esteban JE González-Salazar Laura Vannesa LV Cañón Piñeros Ángela María ÁM Fuentes-Bermúdez Genny Paola GP María Vargas-Escobar Lina L

Palliative care and social practice 20230813

<h4>Background</h4>To achieve universal care and overcome existing barriers, the most effective strategy is to devise an action plan that incorporates palliative care into primary health care (PHC), as recommended by the World Health Organization's (WHO) Astana Declaration. In Colombia, a country with an upper-middle-income status, about 128,000 individuals experience severe health-related suffering (SHS) that necessitates palliative care. Although the country's healthcare system has made steady ...[more]

PMID: 37584058

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Project description:BackgroundNational palliative care plans depend upon stakeholder engagement to succeed. Assessing the capability, interest, and knowledge of stakeholders is a crucial step in the implementation of public health initiatives, as recommended by the World Health Organisation. However, utilising stakeholder analysis is a strategy underused in public palliative care.ObjectiveTo conduct a stakeholder analysis characterising a diverse group of stakeholders involved in implementing a national palliative care plan in three rural regions of an upper-middle-income country.MethodsA descriptive cross-sectional study design, complemented by a quantitative stakeholder analysis approach, was executed through a survey designed to gauge stakeholders' levels of interest and capability in relation to five fundamental dimensions of public palliative care: provision of services, accessibility of essential medicines, palliative care education, financial support, and palliative care vitality. Stakeholders were categorised as promoters (high-power, high-interest), latent (high-power, low-interest), advocates (low-power, high-interest), and indifferent (low-power and low-interest). Stakeholder self-perceived category and knowledge level were also assessed.ResultsAmong the 65 surveyed stakeholders, 19 were categorised as promoters, 34 as advocates, 9 as latent, and 3 as indifferent. Stakeholders' self-perception of their category did not align with the results of the quantitative analysis. When evaluated by region and palliative care dimensions the distribution of stakeholders was nonuniform. Palliative care funding was the dimension with the highest number of stakeholders categorised as indifferent, and the lowest percentage of promoters. Stakeholders categorised as promoters consistently reported a low level of knowledge, regardless of the dimension, region, or their level of interest.ConclusionsAssessing the capability, interest, and knowledge of stakeholders is a crucial step when implementing public health initiatives in palliative care. It allows for a data-driven decision-making process on how to delegate responsibilities, administer financial resources, and establish governance boards that remain engaged and work efficiently.

Project description:Research on knowledge exchange in multi-stakeholder platforms (MSPs) within smallholder farmer settings has primarily focused on adaptive designs and increased innovation rates. This paper addresses a knowledge gap by providing insights into the limited understanding of how knowledge sharing in MSPs can be inclusive of smallholder farmers' knowledge. It shares experiences with a farmer-centred approach to learning and knowledge-sharing with smallholder farmers in Ghana and places this iteratively developed approach within a theoretical perspective. We relate the farmer-centred approach to five design principles inspired by human-centred design rules and inclusive development dimensions. Findings from observations, interviews, and focus group discussions illustrate how the farmer-centred approach creates multifunctional spaces for peer-to-peer learning, interaction with institutional actors, and network building (design principle 1). Prior farmer-centred research ensured that themes addressed were relevant to participant farmers and brought their innovations 'from below' to the table (design principles 2 and 3). A majority representation of farmers, facilitation by local researchers, and organising platform meetings at the district level created a safe space for farmers to share their knowledge and feel included and empowered (design principle 4). Several local institutional actors took ownership of the platform principles, which created opportunities for their manifestation in future collaborations with farmers (design principle 5). However, challenges remain in engaging crucial actors from higher scale levels and reducing donor dependency. The design principles presented in this paper contribute to the genuine inclusion of farmers' knowledge and innovations. We recommend government agencies at the national and district levels incorporate these design principles into their work plans and budgets and prioritise farmers' knowledge and innovation capacity for inclusive learning and knowledge co-creation.Supplementary informationThe online version contains supplementary material available at 10.1007/s13132-023-01661-7.

Project description:BackgroundMany children with serious illnesses are receiving palliative and end-of-life care from pediatric palliative and hospice care teams at home (PPHC@Home). Despite the growth in PPHC@Home, no standardized measures exist to evaluate whether PPHC@Home provided in the U.S. meets the needs and priorities of children and their families.MethodsWe developed and conducted a preliminary evaluation of a family-reported measure of PPHC@Home experiences using a multi-method, multi-stakeholder approach. Our instrument development process consisted of four phases. Item identification and development (Phase 1) involved a comprehensive literature search of existing instruments, guidelines, standards of practice, and PPHC@Home outcome studies, as well as guidance from a PPHC stakeholder panel. Phase 2 involved the initial item prioiritization and reduction using a discrete choice experiment (DCE) with PPHC professionals and parent advocates. Phase 3 involved a second DCE with bereaved parents and parents currently receiving care for their child to further prioritize and winnow the items to a set of the most highly-valued items. Finally, we conducted cognitive interviews with parents to provide information about the content validity and clarity of the newly-developed instrument (Phase 4).ResultsItems were compiled predominantly from three existing instruments. Phase 2 participants included 34 PPHC providers, researchers, and parent advocates; Phase 3 participants included 47 parents; and Phase 4 participants included 11 parents. At the completion of Phase 4, the Experiences of Palliative and Hospice Care for Children and Caregivers at Home (EXPERIENCE@Home) Measure contains 22 of the most highly-valued items for evaluating PPHC@Home. These items include "The care team treats my child's physical symptoms so that my child has as good a quality of life as possible", "I have regular access to on-call services from our care team", and "The nurses have the knowledge, skills, and experience to support my child's palliative or hospice care at home."ConclusionsThe EXPERIENCE@Home Measure is the first known to specifically measure family-reported experiences with PPHC@Home in the U.S. Future work will include formal psychometric evaluation with a larger sample of parents, as well as evaluation of the clinical utility of the instrument with PPHC@Home teams.

Dataset Information

Building an action plan to tackle palliative care inequality through multi-stakeholder platforms.

Background

Objective

Method

Results

Conclusions

Publications

Building an action plan to tackle palliative care inequality through multi-stakeholder platforms.

Similar Datasets

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