Frontiers in health services最新文献

{"title":"A comparative study on person-centered care practice between public and private General Hospitals in Addis Ababa, Ethiopia.","authors":"Mierage Ali, Tesfaye Getachew Charkos","doi":"10.3389/frhs.2024.1482363","DOIUrl":"10.3389/frhs.2024.1482363","url":null,"abstract":"<p><strong>Background: </strong>Person-centered care practice has not yet been fully adopted in low- and middle-income nations such as Ethiopia. It focuses on improving several areas of patient-physician interaction. Despite Ethiopia's rapid growth in healthcare facilities, there is insufficient data available on care practices.</p><p><strong>Method: </strong>A facility-based comparative cross-sectional study was conducted in selected public and private general hospitals in Addis Ababa from May 26 to July 26, 2023. A multistage sampling technique was employed to select the study participants. The data were collected using an interviewer-administered structured questionnaire, entered into Epi Info-7, and exported to SPSS version 27 for analysis. Bivariate and multivariate logistic regression analyses were performed to identify significant factors associated with care practices.</p><p><strong>Results: </strong>A total of 848 patients were involved, with a response rate of 99.5%. The overall magnitude of good care practice was 52.8%, with 34.8% in public hospitals and 70.9% in private hospitals. Factors associated with good care practices in private hospitals included hospital attractiveness (AOR: 3.2; 95% CI: 1.6-6.5), ease of access to services (AOR: 12.1; 95% CI: 6.2-23.3), and privacy of access and care (AOR: 10.89; 95% CI: 5.60-21.19). In contrast, factors associated with good healthcare practices in public hospitals were perceived intimacy with the provider (AOR: 8.85; 95% CI: 4.50-17.43), privacy in accessing care (AOR: 12.1; 95% CI: 6.62-22.16), and the provision of medication information (AOR: 4.39; 95% CI: 2.40-8.03).</p><p><strong>Conclusion: </strong>Overall, 52.8% of participants rated person-centered care practices as good, with private hospitals in Addis Ababa (70.9%) demonstrating a higher prevalence of person-centered care practices compared to public hospitals (34.8%). The factors associated with healthcare practices in both public and private hospitals include hospital type, hospital attractiveness, ease of access to services, privacy in accessing care, perceived intimacy with the provider, and the provision of medication information. We recommend targeted improvements in public hospitals to enhance the quality of PCC.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1482363"},"PeriodicalIF":1.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Becoming a leader for underserved patients-the importance of student run free clinics.","authors":"Ann Marie Cheney, Noah Baltrushes, Daniel Gehlbach, Armando Navarro","doi":"10.3389/frhs.2024.1509964","DOIUrl":"10.3389/frhs.2024.1509964","url":null,"abstract":"<p><p>Many students enter medical school with aspirations of expanding healthcare to underserved communities and reducing healthcare access barriers; yet they lack the leadership skills to achieve this goal. This perspective discusses the role of student-run free clinics in developing medical students' leadership abilities-problem-solving, partnership building, planning, decision-making, and resource acquisition-to address the healthcare needs of marginalized patient populations. It also discusses how fostering leadership skills in the context of serving underserved patients also develops medical students' structural competency and thus awareness of how inequities embedded within hierarchies and social institutions shape health outcomes. We use the example of the development of the Coachella Valley Free Clinic, a student-led and community engaged primary care clinic, to illustrate how student-run free clinics create opportunities for medical students to build leadership skills while addressing the healthcare needs of marginalized patient populations. Medical students, working alongside community health workers and federally qualified healthcare centers, devised a \"pop-up\" clinic model aimed at delivering care that is both culturally sensitive and linguistically appropriate, thereby addressing health disparities rooted in systemic inequality. As we argue, SRFCs create real-world settings where medical students can develop their leadership skills and understanding of inequities in health ultimately contributing to the broader goal of reducing health inequities by improving healthcare access for underserved patient populations.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1509964"},"PeriodicalIF":1.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humanising processes after harm part 2: compounded harm experienced by patients and their families after safety incidents.","authors":"Lauren Ramsey, Joanne Hughes, Debra Hazeldine, Sarah Seddon, Mary Gould, Jo Wailling, Jenni Murray, Siobhan McHugh, Ruth Simms-Ellis, Daisy Halligan, Katherine Ludwin, Jane K O'Hara","doi":"10.3389/frhs.2024.1473296","DOIUrl":"10.3389/frhs.2024.1473296","url":null,"abstract":"<p><strong>Background: </strong>Healthcare organisations risk harming patients and their families twofold. First, through the physical, emotional and/or financial harm caused by safety incidents themselves, and second, through the organisational response to incidents. The former is well-researched and targeted by interventions. However, the latter, termed 'compounded harm' is rarely acknowledged.</p><p><strong>Aims: </strong>We aimed to explore the ways compounded harm is experienced by patients and their families as a result of organisational responses to safety incidents and propose how this may be reduced in practice.</p><p><strong>Methods: </strong>We used framework analysis to qualitatively explore data derived from interviews with 42 people with lived or professional experience of safety incident responses. This comprised 18 patients/relatives, 16 investigators, seven healthcare staff and one legal staff. People with lived and professional experience also helped to shape the design, conduct and findings of this study.</p><p><strong>Findings: </strong>We identified six ways that patients and their families experienced compounded harm because of incident responses. These were feeling: (1) powerless, (2) inconsequential, (3) manipulated, (4) abandoned, (5) de-humanised and (6) disoriented.</p><p><strong>Discussion: </strong>It is imperative to reduce compounded harm experienced by patients and families. We propose three recommendations for policy and practice: (1) the healthcare system to recognise and address epistemic injustice and equitably support people to be equal partners throughout investigations and subsequent learning to reduce the likelihood of patients and families feeling powerless and inconsequential; (2) honest and transparent regulatory and organisational cultures to be fostered and enacted to reduce the likelihood of patients and families feeling manipulated; and (3) the healthcare system to reorient towards providing restorative responses to harm which are human centred, relational and underpinned by dignity, safety and voluntariness to reduce the likelihood of patients and families feeling abandoned, de-humanised and disoriented.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1473296"},"PeriodicalIF":1.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organization Theory for Implementation Science (OTIS): reflections and recommendations.","authors":"Sarah A Birken, Jure Baloh, Michelle C Kegler, Terry T-K Huang, Matthew Lee, Prajakta Adsul, Grace Ryan, Alexandra Peluso, Cheyenne Wagi, Aliza Randazzo, Megan A Mullins, Kristin E Morrill, Linda K Ko","doi":"10.3389/frhs.2024.1449253","DOIUrl":"10.3389/frhs.2024.1449253","url":null,"abstract":"<p><p>Organizations exert influence on the implementation of evidence-based practices and other innovations that are independent of the influence of organizations' individual constituents. Despite their influence, nuanced explanations of organizations' influence remain limited in implementation science. Organization theories are uniquely suited to offer insights and explain organizational influences on implementation. In this paper, we describe the efforts of the Cancer Prevention and Control Research Network's (CPCRN) Organization Theory for Implementation Science (OTIS) workgroup to equip implementation scientists with theory-guided understanding of organizational influences on implementation. We provide a set of recommendations for future efforts to enhance implementation through the use of organization theories and OTIS tools.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1449253"},"PeriodicalIF":1.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing primary care through integrated care pathways: a convergence of theory and practice.","authors":"Waseem Jerjes, Daniel Harding","doi":"10.3389/frhs.2024.1432901","DOIUrl":"10.3389/frhs.2024.1432901","url":null,"abstract":"","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1432901"},"PeriodicalIF":1.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mental health care system for children and adolescents in Greece: a review and structure assessment.","authors":"Lauro Estivalete Marchionatti, Julia Luiza Schafer, Vasiliki Eirini Karagiorga, Panagiota Balikou, Andromachi Mitropoulou, Aspasia Serdari, Giorgos Moschos, Lilian Athanasopoulou, Maria Basta, André Simioni, Julian Vicenzi, Efstathia Kapsimalli, Alexandra Tzotzi, Sotiria Mitroulaki, Katerina Papanikolaou, Kalliopi Triantafyllou, Dimitra Moustaka, Shekhar Saxena, Sara Evans-Lacko, Christos Androutsos, Anastasia Koumoula, Giovanni Abrahão Salum, Konstantinos Kotsis","doi":"10.3389/frhs.2024.1470053","DOIUrl":"10.3389/frhs.2024.1470053","url":null,"abstract":"<p><strong>Background: </strong>The mental health system in Greece faces challenges to complete its transition to a community-oriented model, having significant concerns for child and adolescent care due to lower coverage and service gaps. This component of the mental health system has not been comprehensively evaluated.</p><p><strong>Methods: </strong>We conducted a review of the mental health care system for children and adolescents in Greece. For a field assessment, we directly collected data from mental health services to map availability and distribution. We analyzed the needs of human resources using professional register data and the national census.</p><p><strong>Results: </strong>The National Health Care Service (ESY, <i>Εθνικ</i>ό <i>Σ</i>ύ<i>στημα Υγε</i>ί<i>α</i>ς) is the public health system in Greece, characterized by public governance but significant private participation. Although ESY aims for universal care, gaps in population coverage and high user fees create barriers to access. Embedded within ESY, the mental health system is shifting towards a community-oriented structure since the psychiatric reform. For children and adolescents, there is a developing framework for regionalization and community services, including day centers, inpatient facilities, outpatient departments, and school-based psychoeducational facilities. However, services lack coordination in a stepped care model. Patient pathways are not established and primary care rarely involves child mental health, leading to direct access to specialists. Services operate in isolation due to the absence of online registers. There is no systematic performance monitoring, yet some assessments indicate that professional practices may lack evidence-based guidelines. Our mapping highlighted a scarcity of public structures, with an unbalanced regional distribution and many underserved areas. Child and adolescent psychiatrists are predominantly affiliated with the private sector, leading to professional gaps in the public system.</p><p><strong>Conclusions: </strong>Our assessment identifies an established framework for a community-oriented, universally accessible mental health system, yet several barriers impede its full realization. These include an inconsistent primary healthcare system, a shortage of specialists in the public sector, imbalanced service distribution, lack of coordination among providers, underfunding, and absence of quality monitoring. We propose interventions to promote child and adolescent mental health in primary care, coordinate patient pathways, establish standards of care, and monitor performance.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1470053"},"PeriodicalIF":1.6,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Birthing parent perspectives on measuring the quality of perinatal care: metrics, timing, and process.","authors":"Kristin P Tully","doi":"10.3389/frhs.2024.1473848","DOIUrl":"10.3389/frhs.2024.1473848","url":null,"abstract":"<p><strong>Objective: </strong>Centering birthing parents is critical for improving reproductive health policies and practices. This study investigates patient perspectives on measuring the quality of perinatal care.</p><p><strong>Methods: </strong>A cross-sectional qualitative research study was conducted at an academic medical center in the Southeastern United States. Individuals who had recently given birth participated in audio-recorded interviews between May 2020 and September 2020. This analysis addresses the research question, \"If we were providing quality healthcare for families, how would we know?\" Transcribed and translated responses were inductively coded to develop categories and identify themes.</p><p><strong>Results: </strong>Forty birthing parents participated in the study. Metrics, timing, and process were identified as important components of meaningfully measuring the quality of perinatal care. Recommended metrics included asking patients whether their health priorities were addressed. Additional metrics of importance were whether coping strategies were provided, the clarity of information provided, patient comprehension of health information, the extent to which care planning was collaborative among patients and their healthcare team members, whether clinicians alleviated patient doubts, patient feelings of being taken care of, healthcare team mannerisms, clinician demonstrations of respect for patient autonomy, and postpartum visit attendance. With regard to timing, patients desired that their healthcare team members \"check-in\" with them as part of an ongoing, direct dialog. Birthing parents also wanted opportunities to provide feedback soon after encounters. As part of a robust measurement process, they wanted to share their insights with someone who was not a part of their healthcare team, for maintaining confidentiality. The patients desired a \"serious platform\" with accessible methods for all birthing parents to be able to convey nuanced accounts of their care. They also wanted to hear from the healthcare institutions about their feedback. Birthing parents sought assurances for their perinatal care feedback to be de-identified to protect them from potential retaliation. The participants recognized that they might need to utilize healthcare services from the same institution and individuals in the future.</p><p><strong>Conclusion: </strong>Birthing parents expressed desire for their perinatal healthcare experiences to be understood. Meaningful quality measurement may be promoted through transparent and multimethod opportunities for patients to securely share insights. In addition to healthcare systems communicating assurances of patient confidentiality, institutional feedback in response to patient-reported experiences is recommended.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1473848"},"PeriodicalIF":1.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building trusting relationships in teams to support evidence use and implementation in human services: feasibility and acceptability of a training and coaching approach.","authors":"Allison Metz, Todd M Jensen, Lacy Dicharry, Amanda B Farley","doi":"10.3389/frhs.2024.1353741","DOIUrl":"10.3389/frhs.2024.1353741","url":null,"abstract":"<p><strong>Background: </strong>Professionals who provide implementation support in human service systems describe relationships as being critical to support evidence use; however, developing trusting relationships are not strongly featured in implementation science literature. The aims of this study were to (a) assess the feasibility and acceptability of a theory-driven training and coaching approach for building trusting relationships among members of an implementation team who were supporting the implementation of an evidence-informed program in a public child welfare system in the United States and (b) gauge the initial efficacy of the approach in terms of the development of trusting relationships and subsequent implementation outcomes.</p><p><strong>Methods: </strong>Consistent with a convergent mixed-methods approach, we collected both quantitative and qualitative data to address our research questions. Quantitative methods included an adapted version of the Trusting Relationship Questionnaire, a seven-item measure of psychological safety, and items designed to measure acceptability of the training. Qualitative data were collected through semi-structured interviews with participants.</p><p><strong>Results: </strong>Sixteen individuals participated in the program, consisting of a kick-off training event, five monthly training modules, and five monthly coaching sessions with implementation team leads. Session attendance rates and self-reported satisfaction highlight the general feasibility and acceptability of the training and coaching approach. On average, participants also reported significant increases over time in their perceptions that they were trusted by their team. Results from in-depth interviews further indicated the efficacy of the program in terms of cultivating trust among team members and promoting several elements that were theorized to link trusting relationships to implementation outcomes.</p><p><strong>Discussion: </strong>Findings suggest the training and coaching approach for trust building was acceptable and feasible. Additionally, results indicate the value of the approach in building trust among implementation partners to increase commitment to implementation efforts, promote a culture of learning and psychological safety, and increase participants' sense of capability and motivation for supporting implementation.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1353741"},"PeriodicalIF":1.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultivating the conditions for care: it's all about trust.","authors":"Allison Kooijman, Carolyn Canfield","doi":"10.3389/frhs.2024.1471183","DOIUrl":"10.3389/frhs.2024.1471183","url":null,"abstract":"<p><p>This perspective article shares the viewpoints of two long-standing patient safety advocates who have participated first-hand in the evolution of patient engagement in healthcare quality and safety. Their involvement is motivated by a rejection of the common cruelty of institutional betrayal that compounds harm when patient safety fails. The advocates have sought to understand how it can be that fractured trust spreads so predictably after harm, just when it most needs strengthening. Instead, the abandonment of trust upends healthcare values and effectiveness at interpersonal, systemic and structural levels. They argue that authentic care (healthcare that is truly caring) transcends mere service delivery, thus embodying an inviolable commitment to mutual well-being, compassion and generosity. The advocates identify the influence of social determinants, such as culture, identity, and socioeconomic status, as critical to trust formation, where pathogenic vulnerability exacerbates existing inequalities and further impedes trust. The advocates call for a shift from transactional to relational, trust-based interactions that explore the potential for mobilizing restorative justice principles to repair harm and rebuild trust, enabling dialogue, mutual understanding and systemic improvement. Trust, they assert, is born in relationships, not transactions. The bureaucratic, legal and resource constraints that often impair meaningful interactions, also cause moral distress to healthcare providers and poor care quality for patients. They argue that central to the current healthcare crisis is the fundamental need for genuine connection and trust, framing this as both a practical necessity and a confirmation of humanity as intrinsic to healthcare. The advocates envision a future where patient engagement is integral to patient safety to prioritize epistemic justice, mutual respect and compassionate care, to restore healthcare as a cohesive, supportive and deeply human endeavor. They query what contributions a restorative approach could make to centre trust as necessary for cultivating the conditions for care in our healthcare system.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1471183"},"PeriodicalIF":1.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive scoping review of palliative care development in Africa: recent advances and persistent gaps.","authors":"Fernanda Bastos, Eduardo Garralda, Alvaro Montero, John Y Rhee, Natalia Arias-Casais, Emmanuel Luyirika, Eve Namisango, José Pereira, Carlos Centeno, Vilma A Tripodoro","doi":"10.3389/frhs.2024.1425353","DOIUrl":"10.3389/frhs.2024.1425353","url":null,"abstract":"<p><p>Worldwide 56·8 million people need palliative care (PC), and Africa shows the highest demand. This study updates the 2017 review of African PC development, using a scoping review methodology based on Arksey and O'Malley's framework and the PRISMA-ScR checklist. The review was conducted across PUBMED, CINAHL, Embase, government websites, and the African PC Association Atlas, from 2017 to 2023, charting its progress using the new WHO framework for PC Development, which, in addition to Services, Education, Medicines, and Policies, two new dimensions were incorporated: Research and Empowerment of people and Communities. Of the 4.420 records, 118 met the inclusion criteria. Findings showed increased adult specialised services (<i>n</i> = 675), and 15 of 54 countries have paediatric services. Nonetheless, the ratio of services per population mostly remains under 0,10 per 100.000 inhabitants. PC education was included in undergraduate curricula in 29 countries; despite the rise in morphine availability (28 countries), median consumption remains under 3 mg/per capita/year, and 14 countries presented stand-alone policies. Publications on PC development increased, and 26 countries have National PC Associations. Notwithstanding progress since 2017, significant hurdles remain, highlighting the need for ongoing research and policy development to ensure equitable access to palliative care in Africa.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1425353"},"PeriodicalIF":1.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}