The State of Palliative Care in Nigeria: A Scoping Review.

Abstract

Globally, about 85% of palliative care need is unmet. Africa accounts for 20% and 52% of adult and pediatric palliative care burden worldwide, respectively. Nigeria has progressing palliative care provision but meets only an estimated 0.2% of national need. To describe extant literature detailing palliative care knowledge, implementation, medicine availability, education, policy, vitality, and research in Nigeria, propose areas for future scientific inquiry, and inform interventional targets. Arkey and O'Malley design for scoping reviews reported per the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews guidelines. PubMed, Embase, Cochrane CENTRAL, Web of Science, Scopus, and African Index Medicus were searched in January 2024 and updated in December 2024. Full-text, peer-reviewed articles in English describing palliative care in Nigeria were included. Of the 6116 search results, 290 underwent full-text review and 59 satisfied inclusion criteria. Most studies examined palliative care knowledge, attitudes, and practices while few evaluated implementation practices or interventions. Palliative care awareness in Nigeria is low; however patients, family caregivers, and healthcare professionals have expressed interest in expanded education, infrastructure, and culturally-appropriate delivery models. Persistent challenges include opioid availability, delayed referral, inconsistent education, insufficient institutional and federal policy, and absent professional validation. This review identified gaps in palliative care in Nigeria that can inform interventional targets for national acceptance and equitable delivery. It is critical to prioritize multilevel policy changes to expand access to high-quality palliative care services and mitigate the growing burden of health-related suffering among the seriously ill.