Public preferences and priorities for end-of-life care in Kenya: a population-based street survey

Julia Downing*, Barbara Gomes, Nancy Gikaara, Grace Munene, Barbara A. Daveson, Richard A. Powell, Faith N. Mwangi-Powell, Irene J. Higginson, Richard Harding, Project PRISMA, Natalia Monteiro Calanzani (Member of Consortium)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: End-of-life care needs are great in Africa due to the burden of disease. This study aimed to explore public preferences and priorities for end-of-life care in Nairobi, Kenya.

Methods: Population-based street survey of Kenyans aged >= 18; researchers approached every 10th person, alternating men and women. Structured interviews investigated quality vs. quantity of life, care priorities, preferences for information, decision-making, place of death (most and least favourite) and focus of care in a hypothetical scenario of serious illness with

Results: 201 individuals were interviewed (100 women) representing 17 tribes (n = 90 44.8%, Kikuyu). 56.7% (n = 114) said they would always like to be told if they had limited time left. The majority (n = 121, 61.4%) preferred quality of life over quantity i.e. extending life (n = 47, 23.9%). Keeping a positive attitude and ensuring relatives/friends were not worried were prioritised above having pain/discomfort relieved. The three most concerning problems were pain (45.8%), family burden (34.8%) and personal psychological distress (29.8%). Home was both the most (51.1% n = 98) and least (23.7% n = 44) preferred place of death.

Conclusion: This first population-based survey on preferences and priorities for end-of-life care in Africa revealed that psycho-social domains were of greatest importance to the public, but also identified variations that require further exploration. If citizens' preferences and priorities are to be met, the development of end-of-life care services to deliver preferences in Kenya should ensure an holistic model of palliative care responsive to individual preferences across care settings including at home.

Original languageEnglish
Article number4
Number of pages9
JournalBMC palliative care
Volume13
Issue number1
DOIs
Publication statusPublished - 15 Feb 2014

Keywords

  • Public health
  • Hospices
  • Palliative care
  • Attitude to death
  • Public opinion
  • Africa
  • SUB-SAHARAN AFRICA
  • PALLIATIVE CARE
  • ADVANCED CANCER
  • SOUTH-AFRICA
  • DEATH
  • PERSPECTIVES
  • PERCEPTIONS
  • COUNTRIES
  • SYMPTOMS
  • ADVANCE

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