Written by a group with wide experience of caring for dying children in Africa, this book provides practical, realistic guidance on imporivng access to, and the delivery of palliative care in Africa. It looks at the themes common to palliative care - including communication, assessment, sympotom management, psychosocial issues, ethical dilemmas, end of life care, as well as providing  tips for the professional on compassion and conservation of energy - but retains the focus on the particular needs of the health care professional in Africa. Whilst containing some theory, the emphasis is on practical action throughout.  It will provide health care professionals working in Africa, and other resource-poor settings, with the confidence, knowledge, and capacity to improve care for a terminally ill child in constrained and demanding environments.  

Since 2007, palliative care programmes for children in South Africa have increased from 6 to 58, mainly through the Paediatric Development programme of HPCA. The Bigshoes Foundation has spearheaded the development of paediatric palliative care in hospitals in three provinces.

The rapidly developing field of Palliative Medicine arose from the modern Hospice Movement started by Dame Cicely Saunders in the 1960's. Although there was a considerable gap (20 years) between the founding of the first adult and the first children's hospice, Palliative Care for children is now also a rapidly developing field. This section outlines some of the history of the palliative care movement internationally and in South Africa.

The Association for children with life limiting and life threatening illnesses has classified diseases and conditions in childhood that would benefit from palliative care into 4 main categories.

ACT defines palliative care for children and young people with life-limiting conditions as an active and total approach to care, from the point of diagnosis or recognition throughout the child’s life, death and beyond.

WHO Definition of Palliative Care for Children http://www.who.int/cancer/palliative/definition/en/Palliative care for children represents a special, albeit closely related field to adult palliative care. WHO’s definition of palliative care appropriate for children and their families is as follows; the principles apply to other paediatric chronic disorders (WHO; 1998a):Palliative care for children is the active total care of the child's body, mind and spirit, and also involves giving support to the family. It begins when illness is diagnosed, and continues regardless of whether or not a child receives treatment directed at the disease. Health providers must evaluate and alleviate a child's physical, psychological, and social distress. Effective palliative care requires a broad multidisciplinary approach that includes the family and makes use of available community resources; it can be successfully implemented even if resources are limited. It can be provided in tertiary care facilities, in community health centres and even in children's homes.