Who Zipporah Ali?
Zipporah Ali is currently retired, but was not during the beginning of this project. She then passed responsibilities on to her colleague Esther Muniga.
Dr. Zipporah Ali is a palliative care doctor, working as the Executive Director of Kenya Hospices and Palliative Care Association (KEHPCA). She has extensive experience in leading organizations and teams: (capacity building, team building, mentoring and supervising); technical experience in public health and palliative care; promoting advocacy and policy development to improve palliative care for life-threatening illnesses such as cancer, HIV/AIDS and non-communicable diseases. She also has experience at national, regional and international levels in providing technical assistance to local and international implementing organizations; strategic planning, program design, program planning, implementation and management, including financial and budget oversight and management, program monitoring and evaluation; networking, building partnerships and coalitions, and relationship management.
Who is Esther Muinga?
Esther Muinga is a Coordinator for Pain Relief and Palliative Care at Kenya Hospices and Palliative Care Association based in Nairobi, Nairobi Area.
What is the name and aim of the program?
The name of the program is Improving Cancer Pain Management in 10 New Cancer Treatment Centers in Kenya. The aims of the program are as follows:
- Describe the multidimensional nature of pain (physical, social, emotional and spiritual)
- Identify the basic mechanisms and pathophysiology of chronic cancer pain
- Demonstrate appropriate assessment, measurement and classification of cancer pain
- Discuss effective pharmacologic and non-pharmacologic treatment of cancer pain in both adults and children
- Recognize how to safely and effectively prescribe opioids in a primary care setting
- Assess barriers to pain management and how to minimize these obstacles
- Prevent and manage side effects of medications especially opioids
- Evaluate clinical conditions using case studies to develop a treatment plan
- Analyze ethical issues in pain management
- Outline keys to effective communication about pain
- Relate when and how to make appropriate referrals for specialty care
How was the course conducted? Please include long-term follow-up or mentoring. These plans should include some way of measuring the effectiveness of your program.
It was conducted virtually. A face to face training was not possible due to the COVID-19 Pandemic. The participants completed the 4 week online sessions and 2 day placement at a palliative care unit near them. They were requested to give feedback on the training through an online form. The feedback indicated that the training was beneficial to the trainees and has been avenue for change in practice. Placement has also helped them gain hands on pain management skills at their facilities. This can be a bespoke training that addresses the areas of unmet needs or identified needs. The 4 week sessions served as an introduction to cancer pain management and more training may be required to improve their knowledge and skills.
KEHPCA has a membership program where individual friends of the association can sign up for newsletters, updates on palliative care and pain relief and any other areas of palliative care. The trainees have been requested to register as friends so that they receive any information related to pain management and other areas of palliative care; any opportunities for further learning will be emailed to them for their own capacity building. The trainees were also informed of IASP and its resources on pain management; they have be encouraged to join IASP so that they can be beneficiaries of the rich resources that IASP has to offer. This also gave them an opportunity to be advocates of pain relief for cancer patients and families. KEHPCA has shared with them a hard copy of the beating pain book that serves as a useful resource in pain management.
What was the result of the test scores before and after the course that was administered?
PRE-TEST SCORE- 59%
POST TEST SCORE – 80%
The course dramatically contributed to change in knowledge of participants. The participants also completed 2 day placement at a palliative care center and they acknowledged a change in skills and attitudes towards pain management. The placement aimed to improve their competencies in various aspects of pain management with guidance from the palliative care specialists in the facilities
Do you plan to offer any continued mentoring for your trainees? If so, how?
The team shall continue attending continuous medical education sessions (CMES) organized by KEHPCA. KEHPCA shall also visit the facilities and offer technical support to them. KEHPCA shall organize regular updates for the team for the next 6 months -to December 2021. 3 months after the course, KEHPCA shall administer the post-test to participants to assess retention of knowledge (November 2021 and March 2022).
Do you have any other comments or suggestions for IASP regarding the grants program in developing countries?
The grants were very helpful in improving access to education as funds have been a barrier. The grants should continue being offered. We are grateful that there is flexibility in administration of the funds.
The KEHPCA proposal had to change due to the surge of COVID-19 and a different (virtual) approach taken in implementation of the course. The trainees were initially to be 20 from county facilities but the virtual training enabled training of 34 trainees. There is need to continually engage them so as to ensure that they are updated on pain management and that they also disseminate the information to their colleagues.