Practice and Factors Influencing Palliative Care Services for Cancer Management in Government Established Hospitals in Anambra State, Nigeria

Abstract

Palliative care (PC) is essential for enhancing the quality of life of patients with cancer and other life‑limiting conditions. However, its provision remains inadequate in many government-owned hospitals in Nigeria. This study examined the availability, practice, and associated factors influencing the provision of PC services in cancer management, as perceived by healthcare professionals. A descriptive cross-sectional study was employed in two government hospitals in Anambra State. The study surveyed 222 doctors and nurses. Data was collected by a validated, structured questionnaire and analysed using descriptive and inferential statistics, with the level of significance set at p ≤ 0.05. The response rate was 100%. Most respondents were female (89.2%), nurses (74.3%), and aged 40 years and above (45.0%). Awareness of PC services was highest among respondents aged 30–34 years (100%; n = 55), with a statistically significant association between age and awareness (χ² = 19.67; p = 0.01). Awareness was also higher among female respondents (90.4%; n = 179), which was statistically significant (χ² = 7.93; p = 0.01). Overall, 88.3% of respondents reported that PC services were available in their institutions, although 61.3% rated these services as only moderately available. Palliative care was predominantly provided for patients with cancer and HIV (50.0%). Individualized patient care and symptom control were identified as the most commonly practiced PC components. Key facilitating factors included continuous professional education, adequate training, and supportive learning environments. Major barriers comprised financial constraints (91.0%), inadequate infrastructure (72.1%), and insufficient training (60.4%). Although palliative care services are present in government hospitals, their availability and practice remain suboptimal. Enhancing palliative care in this setting will require strengthened training, increased funding, and robust policy support.