Dying with Dignity: Expanding Palliative Care Access for Neuro-Oncology Patients in Africa.

Dying with Dignity: Expanding Palliative Care Access for Neuro-Oncology Patients in Africa.

Clement Elam , Oluwafemi Amusa, Emmanuel Abiodun Owolabi, Peter Olaniyi, Oluwagbenga Samson ASALU, Isah Salihu YAHAYA
Department of Medicine and Surgery, Faculty of Clinical Sciences,College of Medicine, University of Ibadan, Ibadan, Oyo State Nigeria, Ibadan, Nigeria; College of Health Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria., Ogbomoso, Nigeria; Department of Medicine and Surgery, Benjamin Carson (Snr) College of Health and Medical Sciences – Babcock University, Ilishan Remo, Ogun State, Nigeria., Ilishan Remo, Nigeria; College of Health Sciences, Department of Dentistry and Dental Surgery, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria., Ile-Ife, Nigeria; College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria, Ile-Ife, Nigeria

Introduction and Background
Neuro-oncological diseases, including glioblastoma and meningioma, pose a growing burden in Africa, with rising incidence (227 per 100,000) and high mortality due to delayed diagnosis, limited treatment access, and fragmented healthcare. Palliative care, critical for symptom management (e.g., pain, seizures) and psychosocial support, remains inaccessible to over 75% of Sub-Saharan African patients, exacerbating suffering and reducing quality of life.
Aims and Objectives
This narrative review synthesizes evidence from 64 studies to identify systemic barriers to palliative care for neuro-oncology patients in Africa and propose equity-focused solutions.
Methods
A systematic analysis of peer-reviewed articles, case studies, and reports (2000–2024) was conducted. Inclusion criteria prioritized studies on neuro-oncology epidemiology, palliative care gaps, cultural/policy challenges, and successful interventions in African contexts.
Results
Healthcare barriers: Workforce shortages (e.g., 1 neurosurgeon per 2.4 million in Nigeria), opioid inaccessibility (50% lack liquid morphine), and urban-centric services hinder care. Cultural barriers: Stigma, spiritual beliefs, and misconceptions equate palliative care with “abandonment.” Policy gaps: Only 30% of African nations integrate palliative care into health plans. Case studies highlighted Uganda’s community-based programs and South Africa’s multidisciplinary tumor boards as effective. Early palliative integration, telehealth, and task-shifting to community health workers improved outcomes in resource-limited settings.
Conclusions and Recommendations
Urgent priorities include: 1) Training healthcare workers in palliative care; 2) Decentralizing services via home-based/telehealth models; 3) Policy reforms to ensure opioid access and funding. 4) Community engagement to address stigma. Policymakers, NGOs, and global partners must collaborate to integrate palliative care into national cancer strategies, leveraging partnerships to bridge disparities

Keywords: Palliative care access, neuro-oncology, Sub-Saharan Africa, healthcare disparities, opioid accessibility, cultural stigma, community-based care, policy reform.