Evidence map›Paper›PMID 40696352›Full record

ArticleBMC health services research2025

Barriers and facilitators to the implementation of palliative care services at five tertiary hospitals in nigeria: a qualitative formative study.

Chisom Obiezu-Umeh, Ann Abiola Ogbenna, Lyra S Johnson, Matthew T Caputo, Lisa R Hirschhorn, Tonia Chinyelu Onyeka, Akinwale Mukaila Oyegbade, Geraldine Ugochinyere Ndukwu, Israel Kayode Kolawole, Ayilara Saheed Alao and 3 more

Abstract read
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Chisom Obiezu-Umeh *Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. chisom.obiezuumeh@northwestern.edu.
Ann Abiola Ogbenna *Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Lagos, Nigeria.
Lyra S JohnsonCenter for Global Health Education, Robert J. Havey, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, MD, Illinois, USA.
Matthew T CaputoCenter for Global Health Education, Robert J. Havey, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, MD, Illinois, USA.
Lisa R HirschhornDepartment of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Tonia Chinyelu OnyekaDepartment of Anaesthesia/Pain & Palliative Care Unit, College of Medicine, University of Nigeria, Enugu, Nigeria.
Akinwale Mukaila OyegbadeHospice & Palliative Care Department, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Geraldine Ugochinyere NdukwuDepartment of Family Medicine, University of Port-Harcourt Teaching Hospital, Port-Harcourt, Rivers State, Nigeria.
Israel Kayode KolawoleDepartment of Anaesthesia, University of Ilorin, Ilorin, Nigeria.
Ayilara Saheed AlaoDepartment of Pain and Palliative Medicine, Federal Medical Center, Abeokuta, Ogun State, Nigeria.
Gracia Ker EkeDepartment of Paediatrics, University of Port-Harcourt Teaching Hospital, Port- Harcourt, Rivers State, Nigeria.
Nadia Adjoa Sam-AguduInternational Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria.
Ashti Doobay-PersaudCenter for Global Health Education, Robert J. Havey, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, MD, Illinois, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPalliative care (PC) is critical for improving the quality of life for individuals with life-limiting illnesses, yet it remains inaccessible or underdeveloped in low- and middle-income countries like Nigeria. Understanding the factors influencing PC implementation is a crucial first step toward strengthening health system readiness and responsiveness to meet the growing demand for PC services in Nigeria and similar settings.

methodsWe conducted five in-depth interviews and ten focus group discussions to explore health provider, patient and caregiver perspectives on barriers and facilitators to PC implementation at five geographically diverse PC units in Nigeria. Guided by the Consolidated Framework for Implementation Research (CFIR), qualitative data were analyzed using the framework approach.

resultsBarriers and facilitators spanned all five CFIR domains (Innovation, Outer Setting, Inner Setting, Individuals, and Implementation Process). Barriers to PC implementation included, (1) patient financial constraints, (2) inadequate facility funding and resources, (3) shortage of PC providers, 4) delayed/late referrals, 5) Inaccurate knowledge and negative beliefs about PC among health providers and patients, and (6) substandard opioid medications. Facilitators included, (1) high value for PC among patients and caregivers, (2) positive attitudes and (3) desire for PC knowledge and training among PC providers, (4) strong provider motivation and commitment to improve patient quality of life.

conclusionsOur study identified key multi-level factors influencing PC implementation at PC centers in Nigeria. These findings will inform the expansion and integration of PC services into local health systems across Nigeria.

Indexed as

Health Services AccessibilityPalliative CareTertiary Care CentersAdultCaregiversFemaleFocus GroupsHumansInterviews as TopicMaleMiddle AgedNigeriaQualitative ResearchConsolidated framework for implementation researchImplementation scienceNigeriaPalliative careQualitative content analysis

Identifiers

PMID40696352
PMCPMC12285048

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.