Palliative care is defined by the World Health Organization (WHO) as an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual (WHO, 2003).

Palliative care:

• affirms life and regards dying as a normal process,
• neither hastens nor postpones death,
• provides relief from pain and other distressing symptoms,
• integrates the psychological and spiritual aspects of patient care,
• offers a support system to help patients live as actively as possible until death, and
• offers a support system to help the family cope during the patient's illness and in his or her own bereavement.

The aim of palliative care is the relief of suffering and the promotion of the best possible quality of life for the patient and their family

Education and training is essential for all those involved in the provision of palliative care.
In South Africa there are 98 doctors either qualified or qualifying in the distance learning Diploma or MPhil in Palliative Medicine through the University of Cape Town
Professional Nurses can do the Hospice Palliative Care Association Short Course in Palliative Nursing at 10 Centres of Palliative Learning in South Africa; a B Tech (Palliative nursing) at the Cape University of Technology; or a Masters in palliative nursing.
A variety of training courses are available for different members of the multi-disciplinary team, including training in paediatric palliative care.
At present there are approximately 120 sites in South Africa where palliative care is provided. Some sites are development sites, whilst others provide a high level of palliative care.

Different models of care include:
Community home-based palliative care
Hospital-based palliative care teams
Paediatric palliative care programmes
Outreach programmes to children’s homes; schools and prisons

72 Organisations are members of the Hospice Palliative Care Association of South Africa (HPCA) www.hospicepalliativecaresa.co.za

The National Department of Health and Family Health International are developing a model of community palliative care linked to Primary Health Care clinics; and piloting the model in Limpopo and the Northern Cape.