Advocacy has been one of the key mandates of the Palliative Care Association of Uganda right from its founding. The association was born out of the need to coordinate the work of care providers so as to enable providers speak with one voice on critical issues of care. PCAU’s advocacy work has been instrumental in making pain management medicine available to those in need across the country.
Liquid morphine a pain management medication is now available free of charge to patients suffering from chronic pain. In the face of the high doctor to patient ratio in Uganda, PCAU advocated for a policy to increase the number of morphine prescribers. In 2000, the government of Uganda passed a statute which allowed nurses trained in palliative care to become prescribers of morphine. This milestone made morphine accessible to patients who need it the most in places where a doctor is not readily available.
PCAU continues to provide the oversight of the morphine supply chain because it is a restricted medication. Together with the Ministry of Health, Hospice Africa Uganda, National Medical Stores, and Joint Medical Stores as well as palliative care service providers, PCAU ensures that all protocols for production, supply and prescription of morphine are followed. PCAU provides support supervision for orders and distribution to public, private not-for-profit hospitals and hospices as well as the mentoring of health workers in pain assessment and management.
Access to oral morphine is steadily expanding to lower-level health facilities and this has helped patients in needless pain to have access. Districts are aware that morphine is available and they keenly follow up their orders from National Medical Stores and Joint Medical Stores often with assistance from PCAU. However, there is more work that needs to be done to ensure that all in need access this medication.