{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:11:22Z","timestamp":1785413482043,"version":"3.56.0"},"reference-count":13,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Currently less than 2% of Kenyans with severe symptoms receive palliative care (PC). Moreover, PC services are concentrated in urban settings and most rural healthcare providers have limited PC expertise. Project ECHO\u00ae\u00a0Palliative Care for Western Kenya was developed as part of a hub-and-spoke model for improving primary PC in rural Kenya. The programme is based at Moi University and Moi Teaching and Referral Hospital, a public, tertiary care facility with a catchment of 25 million Kenyans, the majority of whom live in rural settings. Self-reported assessments by primary care providers found the Project ECHO\u00ae Palliative Care for Western Kenya programme improved PC knowledge and clinical skills, increased professional confidence and decreased professional isolation. The training sessions led to an increase in collaborative care management between primary care providers and PC specialists outside of the educational sessions. While a positive finding, it does present challenges to an already small cadre of PC specialists in Western Kenya. A monthly education programme is a useful tool for expanding primary PC services, but optimal clinical care will require increasing the number of speciality PC providers. Effective PC will be most effective when primary and speciality PC are developed in a coordinated fashion.<\/jats:p>","DOI":"10.4102\/phcfm.v17i1.5138","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T10:45:34Z","timestamp":1763721934000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Promoting primary palliative care in Western Kenya using Project ECHO\u00ae"],"prefix":"10.4102","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4770-178X","authenticated-orcid":false,"given":"Hussein","family":"Elias","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04p6eac84","id-type":"ROR","asserted-by":"publisher"}],"name":"Moi University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9607-9910","authenticated-orcid":false,"given":"Sarah","family":"Nyariki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2304-6776","authenticated-orcid":false,"given":"Caitrin M.","family":"Kelly","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03eftgw80","id-type":"ROR","asserted-by":"publisher"}],"name":"Indiana University Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9883-0568","authenticated-orcid":false,"given":"Terry","family":"Vik","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03eftgw80","id-type":"ROR","asserted-by":"publisher"}],"name":"Indiana University Indianapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1415-3668","authenticated-orcid":false,"given":"Kenneth","family":"Cornetta","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04p6eac84","id-type":"ROR","asserted-by":"publisher"}],"name":"Moi University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"ref0","unstructured":"Ministry of Health. Kenya health facility census report. Republic of Kenya. Nairobi: Ministry of Health; 2023."},{"key":"ref1","unstructured":"Ministry of Health. Kenya palliative care policy 2021\u20132030. Policy Document. Republic of Kenya. Nairobi: Ministry of Health; 2021."},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Zubairi H, Tulshian P, Villegas S, Nelson BD, Ouma K, Burke TF. Assessment of palliative care services in western Kenya. Ann Palliat Med. 2017;6(2):153\u2013158. https:\/\/doi.org\/10.21037\/apm.2017.01.02","DOI":"10.21037\/apm.2017.01.02"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Elias H, Dow LA, Boit J, Asirwa CF, Cornetta K. Developing palliative medicine as an accredited medical speciality in Kenya. JCO Glob Oncol. 2022;8:e2200025. https:\/\/doi.org\/10.1200\/GO.22.00025","DOI":"10.1200\/GO.22.00025"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Munday D, Boyd K, Jeba J, et al. Defining primary palliative care for universal health coverage. Lancet. 2019;394(10199):621\u2013622. https:\/\/doi.org\/10.1016\/S0140-6736(19)31830-6","DOI":"10.1016\/S0140-6736(19)31830-6"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Atreya S, Datta S, Salins N. Public health perpective of primary care: A review through the lenses of general practitioners. Indian J Palliat Care. 2022;28(3):229\u2013235. https:\/\/doi.org\/10.25259\/IJPC_9_2022","DOI":"10.25259\/IJPC_9_2022"},{"key":"ref6","unstructured":"World Health Organization. Integrating palliative care and symptom relief into primary health care: A WHO guide for planners, implementers and managers. Geneva: World Health Organization; 2018."},{"key":"ref7","unstructured":"Desicions A. The crucial role of primary palliative care in healthcare [homepage on the Internet]. 2021 [cited 2024 Aug 04]. Available from: https:\/\/www.acpdecisions.org\/the-crucial-role-of-primary-palliative-care-in-healthcare\/"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Carrol Z, Allison C, Eva S, Paul K, Sanjeev S. The impact of project ECHO on participant and patient outcomes: A systematic review. Acad Med. 2016;91(10):1439\u20131461. https:\/\/doi.org\/10.1097\/ACM.0000000000001328","DOI":"10.1097\/ACM.0000000000001328"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Bikinesi L, O\u2019Bryan G, Mekonen T, et al. Implementation and evaluation of Project ECHO telementoring program for the Namibian HIV workforce. Hum Resour Health. 2020;18:61. https:\/\/doi.org\/10.1186\/s12960-020-00503-w","DOI":"10.1186\/s12960-020-00503-w"},{"key":"ref10","unstructured":"Agency for Healthcare Research and Quality. Project ECHO [homepage on the Internet]. 2023 [cited 2025 Jul 20]. Available from: https:\/\/www.ahrq.gov\/patient-safety\/settings\/multiple\/project-echo\/index.html"},{"key":"ref11","unstructured":"Queensland Government. What is ECHO? [homepage on the Internet]. 2025 [cited 2025 Jul 20]. Available from: https:\/\/www.echo.qld.gov.au\/what-is-echo"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Cheptum J, Chemutai SV, Nyambane D, Chelagat D. Training palliative care: A study of public and private institutions in Kenya. Int J Palliat Nurs. 2016;22(4):174\u2013175. https:\/\/doi.org\/10.12968\/ijpn.2016.22.4.174","DOI":"10.12968\/ijpn.2016.22.4.174"}],"container-title":["African Journal of Primary Health Care &amp; Family Medicine"],"original-title":[],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T10:45:37Z","timestamp":1763721937000},"score":1,"resource":{"primary":{"URL":"https:\/\/phcfm.org\/index.php\/phcfm\/article\/view\/5138"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,24]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/phcfm.v17i1.5138","relation":{},"ISSN":["2071-2928","2071-2936"],"issn-type":[{"value":"2071-2928","type":"print"},{"value":"2071-2936","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,24]]},"article-number":"a5138"}}