We are pleased to give some updates on the Palliative care Specialist Fellowship Programme, or the PcSFP, based in Kampala, Uganda. The PcSFP has been made possible through our partner the Palliative care Education and Research Consortium, or PcERC, which works in two national referral hospitals in Kampala. 

Since March 2022, PcSFP plans were officially commenced with an international steering group and dedicated staff. PcERC, with a grant from Cairdeas IPCT, held an education coordinator position to develop materials and support the PcSFP steering group in the curriculum, framework, and programme proposal. Much has been accomplished and we now prepare for the accreditation and establishment of the PcSFP as the first specialist fellowship in palliative care in sub-Saharan Africa. Here’s what you need to know about the PcSFP (to date) and our next steps in launching the fellowship.

Curriculum and Framework

In our last update from July 2022, the initial workings of a curriculum were formed in a benchmarking and writing process by Drs Liz Namukwaya and Kate Howorth, overseen by Dr Mhoira Leng, the Cairdeas IPCT Medical Director. The Association of Palliative Medicine (APM) in the UK supported us to solicit experts of palliative care education in Africa to help design the knowledge, skills, and attitudes and behaviours listed in the curriculum. We also shared the curriculum for independent expert review in the UK as well as a senior faculty review from the Department of Medicine, College of Health Sciences at Makerere University in Kampala, Uganda. The final result is a twenty-page curricula document, rich of global expertise and Africa-specific applications, organised into four domains and twenty-five themes, with learning objectives and their relevant knowledge, skills, attitudes, and behaviours.

As the curriculum underwent final reviews, Dr Liz Namukwaya and Hannah Ikong prepared a competency framework aligned to the curriculum. This framework not only listed the standard for a fellow to complete each theme in the PcSFP, but the standard that must be met by fellowship instructors or lecturers themselves. Competencies are quite important measures in this clinically heavy PcSFP and all competencies include the important attitudes and behaviours associated with transformational learning.

Proposal for Accreditation

Our programme proposal has been built a layer at a time, drawing from deliberations from the international steering group of palliative care specialists in Uganda, the UK and Ireland as well as continued research into accreditation in Uganda. Colleagues who have founded similar sub-specialist clinical fellowships in Uganda (such as Cardiology, Onco-Gynaecology, and Pulmonology/Respiratory) have been helpful resources in sharing their approach to clinical fellowships and accreditation pathways. 

Our proposal, originally written by Dr Kate Howorth in 2022, remains a living document as we discuss options with the Uganda Medical and Dental Practitioners Council (UMDPC) in country as well as the option of later expansion with the East, Central and South Africa College of Physicians (ECSACOP). Last year included networking and stakeholder involvement, such as when  Dr Peace Bagahsa, board co-chair of PcERC gave a ECSACOP conference presentation for our fellowship in August, or Dr Liz Namukwaya and Hannah Ikong introduced the PcSFP to the Uganda Ministry of Health Assistant Commissioner in November. 

Way Forward

2024 has quite a bit in store for the PcSFP! On the accreditation side, we plan to finalise discussions with stakeholders and host institutions in this year, so we can apply for accreditation with the UMDPC and, with time, ECSACOP. Conversations with other palliative care associations and possible education partners are paramount, as well as establishing the partnership with the Uganda Ministry of Health. We also continue to invite international collaboration and discuss virtual contributions such as recorded instruction or one-on-one mentorship of fellows.

In March 2024, the education coordinator for the PcSFP was handed over from Hannah Ikong to Bernadette Basemera, an experienced palliative nurse who has recently supported another institution to accredit their palliative care education programmes. The steering group committee, PcERC and Cairdeas IPCT are all excited to welcome Bernadette to the programme and support this crucial stage in the PcSFP. 

As friends and donors of Cairdeas IPCT, we thank you for your continued support in our vision of a world where palliative care is accessible by all. The PcSFP will met the need for specialist palliative care physicians in Uganda and, we hope someday soon, in East, Central and South Africa regions through ECSACOP.

Acknowledgements

All figures included in this blog post are from the poster of "International collaboration between Uganda and the UK to design Sub Saharan Africa’s first Palliative Care Fellowship programme: mutual benefits and learning." The poster was designed in October 2022 for the Palliaitive Care Congress of the Association of Palliative Medicine by Dr Kate Howorth, Dr Elizabeth Namukwaya, Dr Kathleen McGeough, Dr Kalyani Snell, Hannah Ikong, and Dr Mhoira Leng.