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The Advancement of Palliative Care in Rwanda: Transnational Partnerships and Educational Innovation

Rosa, William, E., MS, AGPCNP-BC, ACHPN, AHN-BC, CCRN-CMC, FCCM; Male, Marcia, A., MS, MTCM, RN; Uwimana, Philomene, MSN, BNE, RN; Ntizimira, Christian, R., MD; Sego, Ruth, MScN, RN; Nankundwa, Evelyne, MSN, RN; Byiringiro, Samuel, BSN, RN; Nsereko, Etienne, MScN, MSc; Moreland, Patricia, J., PhD, MSN, CPNP

Journal of Hospice & Palliative Nursing: June 2018 - Volume 20 - Issue 3 - p 304–312
doi: 10.1097/NJH.0000000000000459
Global Exemplar Series

At the heart of palliative care philosophy lies the requisite of expert collaboration across disciplines, specialties, and organizations to provide patient- and family-centered care. When working in a global health setting, myriad interpersonal and cross-cultural considerations must be acknowledged to promote effective communication and coordination between stakeholders. The purpose of this article is to share the experiences of those working to advance palliative care in Rwanda, East Africa, and examine their collective journeys in practice, education, and research. Through the exemplar of Rwanda's Human Resources for Health Program, this narrative provides contextual wisdom for nurses endeavoring to advance palliative care in resource-poor settings and offers lessons learned along the journey. When working internationally, understanding the identity of nursing against the backdrop of local-national-professional-political culture is crucial. Developing relationships with on-the-ground leaders to guide cultural adaptation is likely the most critical factor. This experience has sparked evolving palliative care research and the continued dissemination of palliative care knowledge. Mutually beneficial partnerships have been, and continue to be, the backbone of palliative care advancement in Rwanda. It is essential that nurses teaching palliative care continue to adapt education to support the ongoing development of culturally relevant palliative care literacy across nations.

William E. Rosa, MS, AGPCNP-BC, ACHPN, AHN-BC, CCRN-CMC, FCCM, is Robert Wood Johnson Foundation Future of Nursing Scholar, School of Nursing, University of Pennsylvania, PA.

Marcia A. Male, MS, MTCM, RN, is staff development coordinator, Mammoth Hospital, Mammoth Lakes, CA.

Philomene Uwimana, MSN, BNE, RN, is assistant lecturer, School of Nursing & Midwifery, College of Medicine & Health Sciences, University of Rwanda, Kigali.

Christian R. Ntizimira, MD, is international fellow in palliative medicine, Global Health and Social Medicine, Harvard Medical School, Boston, MA.

Ruth Sego, MScN, RN, is visiting faculty, Human Resources for Health Program, NYU Rory Meyers College of Nursing, New York, in collaboration with School of Nursing & Midwifery, College of Medicine & Health Sciences, University of Rwanda, Kigali.

Evelyne Nankundwa, MSN, RN, is assistant lecturer, School of Nursing & Midwifery, College of Medicine & Health Sciences, University of Rwanda, Kigali.

Samuel Byiringiro, BSN, RN, is ABC QI advisor, Partners in Health, Kigali, Rwanda.

Etienne Nsereko, MScN, MSc, is senior lecturer, School of Public Health, College of Medicine & Health Sciences, University of Rwanda, Kigali.

Patricia J. Moreland, PhD, MSN, CPNP, is assistant professor, Nell Hodgson Woodruff School of Nursing, Lillian Carter Center for Global Health and Social Responsibility, Emory University, Atlanta, GA.

Address correspondence to William E. Rosa, MS, AGPCNP-BC, ACHPN, AHN-BC, CCRN-CMC, FCCM, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104 (wrosa@nursing.upenn.edu).

The authors have no conflicts of interest to disclose.

© 2018 by The Hospice and Palliative Nurses Association.