Table 1. A framework with examples of content in national palliative care policies in Africa.

This framework provides content outlines of some of the approved and national hospice and palliative care policies in Africa as of May 2016
Country	Disease burden in the country and palliative care rating	Title and status of policy	Content outline	Some areas of impact of national palliative care policies
1. Mozambique	HIV Prevalence (UNAIDS 2012): 11.1% People living with HIV (UNAIDS 2012): 1,600,000 AIDS deaths (UNAIDS 2012): 77,000 WHO Global Palliative Care Atlas 2014 rating of palliative care development: Group 3a with isolated provision up from 2a with just capacity building in previous rating	National Palliative Care Policy, July 2012 (approved)	1. INTRODUCTION 1.1. Contextualisation 1.2. Context at the African Context 2. VISION, MISSION, and GOALS 2.1. Vision 2.2. Mission 2.3. Goals 3. GUIDING PRINCIPLES 3.1. Encourage adequate coordination and organisation of palliative care in the integrated care system 3.2. Develop and create human resources capacity 3.3. Promote work in multidisciplinary networks on care matters and stimulate inter-sectoral actions 3.4. Promote social and community participation to encourage interaction with the Health Unit 3.5. Holistic assistance to patients focused on their quality of life (comfort and reassurance of the patients) 3.6. Development of research to mobilise the practice of PC 4. POLICY: RESPONSIBILITY FOR MANAGEMENT 5. SPECIFIC ACTIONS 6. MONITORING AND EVALUATION 7. BIBLIOGRAPHY ANNEXES Annex 1: DEFINITION OF CONCEPTS	1. The country has identified funding gaps for palliative care implementation and needs support. 2. The country has developed a model of implementation of palliative care at district level. 3. A local oral morphine reconstitution plan is being developed with support from APCA with support from the American Cancer Society.
2. Swaziland	HIV Prevalence (UNAIDS 2012): 26.5% People living with HIV (UNAIDS 2012): 210,000 AIDS deaths (UNAIDS 2012): 5,500 WHO Global Palliative Care Atlas 2014 rating of palliative Care development: Group 3b with generalised provision	Kingdom of Swaziland, Ministry of Health, National Palliative Care Policy, November 2011 (approved)	1. INTRODUCTION 1.1. Background to Palliative Care 1.2. Swaziland’s experience in the provision of palliative care 1.3. Opportunities 1.4. Policy statement 1.5. Policy Environment 2. VISION AND MISSION STATEMENTS 3. JUSTIFICATION OF THE PALLIATIVE CARE POLICY 3.1. Rationale for policy 4. GOALS AND OBJECTIVES OF PALLIATIVE CARE POLICY 4.1. Overall goal 4.2. Objectives 5. GUIDING PRINCIPLES OF PALLIATIVE CARE 5.1. Human right based approach 5.2. Multisectoral approach 5.3. Quality assurance 5.4. Meaningful involvement of people living with life-limiting illnesses 5.5. Holistic and comprehensive management 6. POLICY APPLICATION 6.1. Policy Issue 6.2. Key policy Issues 7. POLICY FRAMEWORK 7.1. Policy statements and strategies 7.2. Service delivery including palliative care for carer through decentralisation of palliative care services 7.1.1. Policy statement 7.1.2. strategies 7.2. Service availability, equity, and equality 7.2.1. policy statement 7.2.2. strategies 7.3. Quality improvement and assurance 7.3.1. Policy statement 7.3.2. strategies 7.4. Communication and advocacy 7.4.1. Policy statement 7.4.2. Strategies 7.5. Capacity building into all training sessions 7.5.1. Policy statement 7.5.2. Strategies 7.6. Supervision 7.6.1. Policy statements 7.6.2. Strategies 7.7. Referral system 7.7.1. Policy statement 7.7.2. Strategies 7.8. Monitoring and Evaluation 7.8.1. Policy statement 7.8.2. Strategy 7.9. Coordination of care and services 7.9.1. Policy statement 7.9.2. Strategies 7.10. Institutional framework for implementation 7.10.1. Policy implementation responsibilities 7.10.2. Policy statement 7.10.3. Strategies 8. LEGISLATION 8.1. Policy statement 8.2. Strategies 9. RESOURCE IMPLICATIONS 9.1. Financial resources 9.2. Human and institution resources 9.3 Training and supervisory tools 10. POLICY EVALUATION 11. POLICY REVISION	1. National system now avails reconstituted oral morphine for palliative care. 2. Palliative care training has been embarked on.
3. Zimbabwe	HIV Prevalence (UNAIDS 2012): 14.7% People living with HIV (UNAIDS 2012): 1,400,000 AIDS deaths (UNAIDS 2012): 39,000 WHO Global Palliative care Atlas 2014 rating of palliative care development: group 4a with preliminary integration	The National Palliative Care Policy August 2014 (Approved)	FOREWORD ACKNOWLEDGMENTS ACRONYMS INTRODUCTION • PALLIATIVE CARE CONCEPT • RATIONALE FOR A NATIONAL PALLIATIVE CARE POLICY IN ZIMBABWE • MODELS FOR PALLIATIVE CARE IMPLEMENTATION • BACKGROUND OF PALLIATIVE CARE IN ZIMBABWE • GOAL/PURPOSE OF THE PALLIATIVE CARE POLICY Vision Mission Aims GUIDING PRINCIPLES FOR PALLIATIVE CARE POLICY PRINCIPLE 1: HUMAN RIGHTS • Preamble • Policy statements PRINCIPLE 2: SUSTAINABLE PALLIATIVE CARE • Preamble • Policy statements PRINCIPLE 3: ACCESSIBLE PALLIATIVE CARE • Preamble • Policy statements PRINCIPLE 4: HOLISTIC SERVICES FOR QUALITY OF LIFE • Preamble • Policy statements PRINCIPLE 5: CHILDREN’S PALLIATIVE CARE • Preamble • Policy statements PRINCIPLE 6: EDUCATION, TRAINING, AWARENESS AND SUPPORT FOR PALLIATIVE CARE • Preamble • Policy statements PRINCIPLE 7: RESEARCH AND EVIDENCE BASED PRACTICE • Preamble • Policy statements PRINCIPLE 8: MONITORING AND EVALUATION OF PALLIATIVE CARE • Preamble • Policy statements GLOSSARY REFERENCES APPENDIX
4. Malawi	HIV Prevalence (UNAIDS 2013): 15.2% People living with HIV (UNAIDS 2012): 1,000,000 AIDS deaths (UNAIDS 2012): 48,000 WHO Global palliative care Atlas 2014 rating of palliative Care development: Group 4a with preliminary integration up from category 3 in previous rating	The national policy was approved in 2014	FOREWORD ACKNOWLEDGMENTS LIST OF ACRONYMS AND ABBREVIATIONS GLOSSARY 1. INTRODUCTION 1.1. Background 1.2. Malawi’s experience in the provision of palliative care 1.2.1. Implementation of palliative care services 1.2.2. Palliative care education 1.2.3. Availability of essential medicines 1.2.4. Appropriate policies 1.3. Rationale for a palliative care policy 1.4. Linkage with other relevant policies 2. VISION AND MISSION 2.1. Vision 2.2. Mission statement 3. BROAD POLICY DIRECTIONS 3.1. Overall policy goal 3.2. Policy outcome 3.3. Policy objectives 3.4. Guiding principles 4. POLICY APPLICATION 4.1. Policy use 4.2. Key policy issues 5. POLICY STATEMENTS 5.1. Equitable access to quality and comprehensive palliative care services 5.2. Access to pain relieving medicines, particularly opioids. 5.3. Capacity building 5.4. Resource allocation 5.5. Information, education, and communication (IEC) 5.6. Patient and family participation 5.7. Research and results dissemination 5.8. Coordination and supervision 5.9. Referral system 5.10. Motivation 5.11. Palliative care for paediatric patients 6. IMPLEMENTATION ARRANGEMENTS 6.1. Ministry of health 6.2. Zonal offices 6.3. Central hospitals 6.4. District health offices: 6.5. Health centres 6.6. Professional regulatory boards 6.7. Central medical stores and facility pharmacies 6.8. Civil society 6.9. Health care training institutions 6.10. Patients, families, and communities 7. IMPLEMENTATION PLAN 8. MONITORING AND EVALUATION 9. POLICY REVIEW	1. National palliative care need estimate has been done. 2. National reporting mechanisms for palliative care is in place at the ministry of health. 3. Government is covering 58% of all palliative care provision while churches and NGOs cover the rest. 4. Local reconstitution of morphine powder into oral morphine is in place. 5. Morphine now available in government and faith based health units. 6. Palliative care training has been boosted and the country has over 300 trainers.
5. Tanzania	HIV Prevalence (UNAIDS 2012): 4.1% People living with HIV (UNAIDS 2012): 1,500,000 AIDS deaths (UNAIDS 2012): 80,000 WHO Global palliative care Atlas 2014 rating of palliative Care development: Group 4a with preliminary integration up from category 3 in previous rating	Approved in 2014	1. INTRODUCTION 2. VISION AND MISSION 3. GOALS AND OBJECTIVES 4. GUIDING PRINCIPLES 5. POLICY APPLICATION AND USE 6. POLICY ISSUES, STATEMENTS, AND STRATEGIES 7. POLICY LEGISLATION 8. RESOURCE MOBILISATION 9. POLICY EVALUATION AND REVISION 10. ROLES AND RESPONSIBILITIES OF KEY ACTORS	1. Expansion of palliative care sites with both government and NGO sites offering. 2. Decentralisation of oral morphine reconstitution to regional centres. 3. Integration of palliative care into teaching of health care workers.