This project will support a trip to Botswana and Malawi to advance oncology palliative care in Sub-Saharan Africa through advocacy, education, and partnership-building. Despite the growing burden of cancer in the region, access to palliative care remains extremely limited due to workforce shortages, lack of culturally adapted tools, and inadequate integration into oncology services.
During this trip, I will work alongside local palliative care clinicians, oncology teams, and interdisciplinary providers to strengthen regional networks and scale up evidence-based care. Activities will include supporting clinicians and community partners in presenting their palliative care projects; providing education and information on a culturally sensitive nurse-led Symptom Toolkit intervention designed to improve symptom assessment and management; and engaging key partners in the use and validation of a newly revised measure of the Quality of Dying and Death to better capture patient and family experiences in local contexts. I will also provide mentorship and technical assistance to help expand an emerging oncology palliative care clinic in Malawi.
By strengthening local capacity, supporting knowledge exchange, and advocating for integrated palliative care in oncology, this project will help improve quality of life and end-of-life care for people with advanced cancer in resource-limited settings — ensuring that patients and families receive compassionate, culturally relevant care when they need it most.
This project will directly benefit people living with advanced cancer and their families in Botswana and Malawi, where the need for palliative care is urgent yet profoundly unmet. Cancer incidence is rising across Sub-Saharan Africa, but many patients are diagnosed at late stages, often with significant pain and other distressing symptoms. Limited access to opioids, trained palliative care providers, and culturally relevant care models means that too many patients suffer unnecessarily at the end of life.
The primary population served includes adults with advanced cancer, their caregivers, and families who shoulder the physical, emotional, and financial burden of serious illness. This project also supports local clinicians, nurses, social workers, and community health workers who deliver front-line palliative care, often with minimal resources and training opportunities. This patient population has been prioritized because they face multiple barriers to quality palliative care: stigma, lack of trained providers, inadequate health system integration, and few culturally adapted interventions. We aim to strengthen the capacity to deliver compassionate, patient-centered care.
This project will strengthen oncology palliative care capacity in Botswana and Malawi by equipping local clinicians and interdisciplinary teams with tools, training, and partnerships to deliver high-quality, culturally relevant care. The expected impact includes improved symptom management for people with advanced cancer, greater use of evidence-based palliative care interventions, and enhanced ability to advocate for integrated palliative services within national cancer control strategies.
Learnings and partnerships will carry forward through sustained virtual collaboration, shared training materials, and joint research initiatives. By investing in the capacity and leadership of local palliative care champions, this project ensures that the impact is not just a one-time intervention but an ongoing effort to scale up accessible, high-quality palliative care across Sub-Saharan Africa, ultimately improving quality of life and dignity at the end of life for patients and their families.
September–October 2025
This two-week trip to Botswana and Malawi advanced the integration of oncology palliative care across Sub-Saharan Africa through education, advocacy, and partnership-building. With cancer incidence rising in the region and access to palliative services still limited, the visit aimed to strengthen local capacity, foster collaboration, and promote culturally relevant, patient-centered care.
Objectives
The trip’s objectives were to:
1. Support local clinicians and researchers in presenting ongoing palliative care projects.
2. Provide education on a culturally adapted, nurse-led Symptom Toolkit intervention to enhance symptom assessment and management.
3. Engage regional partners in refining and validating the Quality of Dying and Death (QODD)-Revised Global Version measure for local use.
4. Build lasting partnerships and mentorship networks to strengthen oncology palliative care systems.
Key Activities
The centerpiece of the trip was facilitation of a research workshop at the African Palliative Care Association Meeting that was attended by more than 50 participants—including clinicians, nurses, researchers, and trainees—from across the African continent. The event featured:
• Presentations on current oncology palliative care research.
• A “Bright Ideas” session to share innovative ideas, provide feedback on proposed projects, and foster collaboration.
Implementation of the Symptom Toolkit was presented, emphasizing culturally sensitive communication and nurse-led symptom management strategies, as well as a presentation of the collaborative work on the Revised Global Version of the Quality of Dying and Death including review of its Chichewa translation, cultural adaptation, and content validity testing along with future plans for validation.
The trip resulted in new and strengthened partnerships among palliative care practitioners, educators, and researchers across the region. Collaborative commitments were made to pilot the Symptom Toolkit and QODD measure in clinical settings and collaborate on future research projects and partnerships. This trip reinforced the power of partnership and shared vision in improving care for people with advanced cancer. The dedication of local teams working with limited resources was deeply inspiring. By investing in education, evidence-based tools, and collaborative networks, we took meaningful steps toward ensuring that patients and families across Sub-Saharan Africa receive compassionate, culturally relevant palliative care. The progress achieved during this trip, and the partnerships that grew from it, represent an important stride toward sustainable, high-quality oncology palliative care across the region.
