Uganda
The clearest case of prescriber-scope reform paired with public supply.
9 domains reviewed · 9 high-confidence · 6 dated estimates · 5 material gaps
WHO region: Africa. World Bank income group: Income group not yet retrieved.
- Domains reviewed
- 9 of 9
- Hospice: 4 of 4
- Backed by a primary document
- 2 of 9
- Open questions
- 9
- Sources behind this dossier
- 28
- Newest source 2026
Lessons from Uganda
- When nearly all hospice income comes from external donors, services face cuts as soon as donor priorities shift, so a public funding line is worth building early.36,12
- Mobile and home-based hospice teams linked to a partner hospital for inpatient care can serve patients without a stand-alone inpatient building.284
- Trained community volunteers can extend a hospice's reach into homes and help find patients, but they need ongoing training, supplies, transport and phone support to keep going.392,394
- A hospice can review long-term oral morphine patients for addiction and diversion while keeping morphine available, focusing extra care on chronic non-cancer pain.597
- Formal referral from pediatric oncology to the nearest palliative care provider is a key step, since children without referral did not continue care after discharge.287
Palliative care
Is morphine available in Uganda?
Opioid supply. Is a therapeutic opioid physically available in the wards that need it? Every country on this question
Government supplies free oral morphine as an essential medicine and has co-manufactured it nationally since 2011.12
How does Uganda regulate opioids for pain?
Narcotics regulation. What licensing regime governs stocking and dispensing, and when did it last change? Every country on this question
Statutory Instrument 2004 No. 24, made under the National Drug Policy and Authority Statute, carries the prescriber expansion and ties prescribing to the Ministry of Health guidelines for handling Class A drugs.34
Who can prescribe morphine in Uganda?
Prescriber authority. Who is legally allowed to prescribe, and can that group be widened? Every country on this question
A clinical officer or nurse holding a certificate in specialist palliative care may prescribe and supply the listed morphine preparations, under the 2004 narcotic analgesic regulations.12,34
How does palliative care reach patients in Uganda?
Service delivery. Through what structure does care actually reach a patient at home? Every country on this question
- 226 facilitiesSOURCE-CHECKED · 2020 DATA
Accredited palliative care facilities, Uganda, 202035
Last checked 2026-09-07.
Cite this figure: - 30 districts of 135SOURCE-CHECKED · 2020 DATA
Districts with no accredited facility, Uganda, 202035
Last checked 2026-09-07.
Cite this figure: - 88.50 percentSOURCE-CHECKED · 2020 DATA
Population living in a district with a service, Uganda, 202035
Last checked 2026-09-07.
Estimated against the 2014 census.
Cite this figure:
Who staffs the accredited facilities, and how many carry a certificated prescriber?
Help answer it:Search PubMedWho pays for palliative care in Uganda?
Financing. Who pays for the drug, the visit and the workforce? Every country on this question
Government support to stand-alone services arrives as medicines, training and tax exemption rather than cash.36
How are palliative care clinicians trained in Uganda?
Training and recognition. What credential exists, who awards it, and does anyone recognize it? Every country on this question
- 12 monthsSOURCE-CHECKED · 2022 DATA
Diploma in Clinical Palliative Care, course length, Uganda, 202237
Last checked 2026-09-07.
Cite this figure:
The Diploma in Clinical Palliative Care is open to registered nurses and clinical officers, and its graduates may prescribe oral liquid morphine.37
How does Uganda prevent opioid misuse without blocking pain relief?
Opioid safeguards. How are misuse and diversion controlled, and are treatment and naloxone available, without blocking pain relief? Every country on this question
Uganda lets trained nurses prescribe oral morphine, and Hospice Africa Uganda assessed 34 patients on long-term oral morphine, finding two cases of addiction and one probable diversion among people with chronic non-cancer pain. Uganda introduced methadone treatment in 2020, with 55.2% of 343 clients retained at 12 months, and a Kampala pilot started 55 people on buprenorphine. Patients and supply staff still report legal barriers to an adequate opioid supply for pain.288,597,598,599,600
Does Uganda run any prescription monitoring for oral morphine, and is naloxone available to palliative care teams or to people who use drugs?
Help answer it:Search PubMedHow do children get palliative care in Uganda?
Children's palliative care. How do children with life-limiting conditions get palliative care and the medicines they need? Every country on this question
Uganda provides pediatric palliative care across the health system from neonates to young adults, yet in the Busoga sub-region 96.1% of children with cancer did not continue palliative care after discharge, and none of them had been referred to their nearest provider. Children were 6% of attendees at the Fort Portal hospital palliative care unit.287,602,603,288
How many children receive palliative care in Uganda each year, and are child-appropriate morphine formulations stocked outside referral hospitals?
Help answer it:Search PubMedHow is palliative care delivered during crises in Uganda?
In Adjumani District, where refugees and hosts live in equal numbers, palliative care was not routinely integrated at baseline and increased after training, mentorship and community sensitization. Refugees with advanced illness in three settlements describe trauma, unmet basic needs and inconsistent care, and a mobile symptom-reporting app was feasible in Bidibidi settlement.604,605,606
How are opioid supplies and palliative care funding secured for refugee settlements within Uganda's national system?
Help answer it:Search PubMedHospice care in Uganda
How the hospice model works here, who can use it, who pays and who it reaches. Covered 4 of 4.
What does hospice care look like in Uganda?
Hospice model. What does hospice mean here, who runs it, and in what settings? Every country on this question
Hospice in Uganda means NGO-run services that mostly deliver home-based, outpatient and day care; Hospice Africa Uganda has operated since 1993. Kitovu Mobile Hospice offers mobile and home care and also cares for inpatients at Kitovu Hospital. Ugandan sources use hospice and stand-alone palliative care organization almost interchangeably.284,285,36
How many of Uganda's hospices run their own inpatient beds, and which are faith-based?
Help answer it:Search PubMedWho can get hospice care in Uganda?
Hospice eligibility. Who can enter hospice, on what criteria, and how late do patients arrive? Every country on this question
Hospice Africa Uganda serves patients with AIDS as well as cancer, and people living with AIDS who were referred still presented with advanced disease after long suffering. Poverty and fear of stigma around disclosing an AIDS diagnosis acted as barriers to seeking help (single organization).286,12
Are there written admission criteria or prognosis rules for Ugandan hospices, and at what stage do cancer patients arrive?
Help answer it:Search PubMedWho pays for hospice care in Uganda?
Hospice funding. Who pays for hospice care: a public benefit, insurance, charity or families? Every country on this question
Stand-alone hospice and palliative care organizations in Uganda get 93% of their funding from donations, and 94% of those donations come from outside the country. Government support comes mainly as medicines, training and tax payments, and oral liquid morphine made at Hospice Africa Uganda is given free to prescribed patients.36,12
Has government budget support for hospices changed since public hospitals were told to provide palliative care?
Help answer it:Search PubMedHow many people reach hospice in Uganda?
Hospice reach. How many dying people use hospice, and who is left out? Every country on this question
Only 11% of Ugandans who need palliative care receive it, with distance to hospitals and hospices and transport costs among the barriers. In Busoga sub-region, 96.1% of children with cancer did not continue palliative care after discharge, and none of them had been referred to a nearby provider. Rural, poor and pediatric populations are the groups most often left out.284,287,288
How many patients do Ugandan hospices serve each year relative to national deaths?
Help answer it:Search PubMedWhat fills the gap in Uganda
How people get care outside formal services: families, faith communities, volunteers, health workers, healers, other medicines and charity. Described, not scored.
- Family caregiving
- Volunteers and compassionate communities
Hospice Africa Uganda trained community volunteer workers to support patients in their own homes and identify people who need care, acting as a bridge to the hospice. Volunteers cited a cultural wish to help others and gained standing in their communities. A 2026 study of eight volunteers in Wakiso District reported gaps in training, supplies, transport funds and phones with data.392,393,394
Single-site evidenceSelf-reported- Community health workers and home-based care
In Mbale and Jinja, community systems built around HIV care provided personal, livelihood, nutritional and bereavement support and strengthened referrals into palliative care.399
Subnational evidence- Traditional and complementary healers
At a referral hospital in Mbarara, 56.8% of patients with cancer used herbal medicine, and use was more likely with stage III or IV disease. At the Uganda Cancer Institute, 69.9% of children with cancer used traditional or complementary medicine, mostly spiritual practices and herbal remedies alongside conventional treatment.397,398
Single-site evidence
Sources cited here
- 12Merriman A, Mwebesa E, Zirimenya L.
Improving access to palliative care for patients with cancer in Africa: 25 years of Hospice Africa. Ecancermedicalscience 2019;13:946. DOI 10.3332/ecancer.2019.946. Nurse and clinical officer prescribing authority; free government oral morphine; local manufacture from 2011.
- 34Republic of Uganda, Statutory Instruments 2004 No. 24.
National Drug Authority (Prescription and Supply of Certain Narcotic Analgesic Drugs) Regulations, made under the National Drug Policy and Authority Statute 1993. Rule 4 authorises a clinical officer or nurse holding a certificate in specialist palliative care to prescribe and supply listed morphine preparations. Full text hosted by the Palliative Care Association of Uganda.
- 35Kagarmanova A, Mwesiga MD, Sisk ML, et al.
Palliative care in Uganda: quantitative descriptive study of key palliative care indicators 2018 to 2020. BMC Palliative Care 2022;21:55. DOI 10.1186/s12904-022-00930-7. Accredited facility and district counts, population coverage against the 2014 census, and the public-sector share of facilities.
- 36Amandua J, Kimaro MS, Mwebesa E, Taremwa IM, Atuhairwe C.
The financing of stand-alone palliative care services in Uganda: analysis of the implications for sustainability. BMC Palliative Care 2019;18(1):48. DOI 10.1186/s12904-019-0434-5. External share of donations, income-generating share, and the government contribution in medicines, training and tax exemption rather than cash.
- 37Institute of Hospice and Palliative Care in Africa, Hospice Africa Uganda.
Diploma in Clinical Palliative Care: a twelve month programme open to registered nurses and clinical officers, whose graduates may prescribe oral liquid morphine under Statutory Instrument 2004 No. 24. Programme materials and partner reporting, with the first advanced diploma nursing cohort graduating in 2022.
- 288Downing J, Ndagire M, Irumba LC
Striving for Equity, Justice, and Access to Palliative Care Through Cancer and Palliative Nursing in Uganda: A Narrative Review. Semin Oncol Nurs 2026;42(3):152249. Narrative review supported by authors' expert knowledge on nursing and equity in Ugandan palliative care; authors are sector advocates. Abstract read.
- 597Duncan B, Natuhwera G, Nassuuna D, et al.
Serious Adverse Drug Reactions to Long-Term Oral Liquid Morphine in Patients with Chronic Pain: A Cross-Sectional Survey in Palliative Care. J Pain Res 2025;18:2361-2371. Survey at Hospice Africa Uganda of patients on long-term oral liquid morphine assessed for serious adverse reactions, including addiction and diversion; single hospice reviewing its own patients (self-evaluation). Abstract read.
- 598Mudiope P, Mutamba BB, Komuhangi L, et al.
Retention of people who inject drugs enrolled in a 'medications for opioid use disorder' (MOUD) programme in Uganda. Addict Sci Clin Pract 2024;19(1):39. Retrospective cohort of 343 people who inject drugs started on methadone in Uganda's program in Kampala, 2020 to 2022, reporting 12-month retention; single clinic. Abstract read.
- 599Dickson-Gomez J, Tarima S, Twaibu W, et al.
Feasibility, Acceptability, and Preliminary Efficacy of a Pilot Study To Integrate Buprenorphine into a Harm-reduction Drop-in-Center in Kampala, Uganda. AIDS Behav 2025;30(5):1338-1351. Pilot study integrating buprenorphine into a harm-reduction drop-in center in Kampala; 62 people screened; small uncontrolled pilot. Abstract read.
- 600Weiss Goitiandia S, Namisango E, Luyirika EBK, et al.
The legal needs of people receiving palliative care in Uganda: A multi-method assessment to advance universal health coverage. Palliat Care Soc Pract 2025;19:26323524251347652. Multi-method assessment of legal needs among 384 people receiving palliative care at three Ugandan sites, with key informant interviews including medicines supply staff. Abstract read.
- 601Buyinza N, Nkhoma K, Namisango E, et al.
Nurse-led palliative care for multidrug-resistant tuberculosis: a parallel, single-blind, pragmatic, randomised controlled trial in Uganda. Lancet Glob Health 2025;13(8):e1448-e1457. Pragmatic randomized trial of nurse-led palliative care, including psychosocial support, for 154 adults with multidrug-resistant tuberculosis in three Ugandan public hospitals; funded by Open Society Foundations. Abstract read.
- 287Ajambo M, Mwaka S, Nyanzi JG, et al.
Paediatric palliative care following hospital discharge: Prevalence and factors associated with non-continuity of palliative care for children with cancer in Busoga sub-region-eastern Uganda; A mixed methods study. PLOS Glob Public Health 2026;6(1):e0004210. Mixed-methods study at two tertiary facilities and one hospice centre finding 96.1% non-continuity of pediatric palliative care; one sub-region, first author affiliated with Ministry of Health. Abstract read.
- 602Batanda I, Birungi D
A descriptive analysis of hospital-based palliative care services: a case study from Fort Portal Regional Referral Hospital, Uganda. BMC Health Serv Res 2026. Descriptive case study of 2,133 attendances at the palliative care unit of Fort Portal Regional Referral Hospital, July 2019 to May 2026; single site. Abstract read.
- 603Downing J, Namukwaya E, Nakawesi J, et al.
Shared-decision-making and communication in paediatric palliative care within Uganda. Curr Probl Pediatr Adolesc Health Care 2024;54(1):101556. Review of shared decision-making and communication in pediatric palliative care in Uganda; authors from national palliative care organizations (self-evaluation). Abstract read.
- 284Mah K, Namisango E, Luyirika E, et al.
Quality of Dying and Death of Patients With Cancer in Hospice Care in Uganda. JCO Glob Oncol 2023;9:e2200386. Bereaved-caregiver survey (N=202) at two Ugandan hospices (Kitovu Mobile Hospice and Hospice Africa Uganda) that describes both services and reports poor symptom control near death; two-site scope, co-authors include African Palliative Care Association staff. Full text read.
- 285Campbell J, Buyinza N, Hauser J
Perspective on Care at the End of Life at Hospice Africa Uganda. J Palliat Med 2018;21(7):901-906. Survey of 46 patients, 51 caregivers and 25 providers at Hospice Africa Uganda (Kampala and satellites) on end-of-life priorities; single organization, one co-author is HAU staff. Abstract read.
- 286Too W, Watson M, Harding R, et al.
Living with AIDS in Uganda: a qualitative study of patients' and families' experiences following referral to hospice. BMC Palliat Care 2015;14:67. Qualitative interviews with 22 AIDS patients and 20 caregivers newly referred to Hospice Africa Uganda; single organization. Abstract read.
- 392Jack BA, Kirton J, Birakurataki J, et al.
'A bridge to the hospice': the impact of a Community Volunteer Programme in Uganda. Palliat Med 2011;25(7):706-15. Qualitative evaluation (64 interviews) of the Hospice Africa Uganda Community Volunteer Programme; volunteers acted as a bridge to the hospice. Co-authored by the hospice founder, so partly a self-evaluation. Abstract read.
- 394Mwesiga MD, Irumba LC, Low CSL, et al.
Bridging the gap: Understanding the needs of community health volunteers to enhance palliative care delivery. Palliat Care Soc Pract 2026;20:26323524261473935. Qualitative interviews with eight community health volunteers in one parish of Wakiso District, Uganda, on training, resource and phone needs. Small single-site sample; first author affiliated with the national palliative care association. Abstract read.
- 395Najjuka SM, Iradukunda A, Kaggwa MM, et al.
The caring experiences of family caregivers for patients with advanced cancer in Uganda: A qualitative study. PLoS One 2023;18(10):e0293109. Descriptive qualitative study of 12 family caregivers of patients with advanced cancer at the Uganda Cancer Institute (Kampala). Abstract read.
- 396Dipio R, Acuda W, Namisango E, et al.
Prevalence and factors associated with depressive symptoms among family caregivers of palliative care patients at Hospice Africa Uganda. Palliat Support Care 2022;20(3):375-382. Mixed-methods study of 161 family caregivers at Hospice Africa Uganda; 46% had depressive symptoms on PHQ-9. Single hospice. Abstract read.
- 393Jack BA, Kirton JA, Birakurataki J, et al.
The personal value of being a palliative care Community Volunteer Worker in Uganda: a qualitative study. Palliat Med 2011;26(5):753-9. Qualitative study of 32 Community Volunteer Workers and 11 clinical staff at Hospice Africa Uganda sites on why they volunteer and what it means to them. Same program team as the impact evaluation. Abstract read.
- 399Mburu G, Oxenham D, Hodgson I, et al.
Community systems strengthening for HIV care: experiences from Uganda. J Soc Work End Life Palliat Care 2013;9(4):343-68. Qualitative interviews and focus groups in Mbale and Jinja, Uganda, on the role of community systems in HIV palliative care. First author from an international HIV NGO. Abstract read.
- 397Nono SM, Kyomya J, Tolo CU, et al.
Factors associated with herbal medicine use among patients with cancer attending a tertiary hospital in Southwestern Uganda: a cross-sectional study. Discov Oncol 2025;16(1):2163. Cross-sectional survey of 303 patients with cancer at Mbarara Regional Referral Hospital; 56.8% used herbal medicine. Single tertiary site. Abstract read.
- 398Egesa B, Batte A, Kambugu JB, et al.
Exploring the Use of Traditional and Complementary Medicine in Pediatric Oncology: A Mixed-Methods Study From Uganda. Pediatr Blood Cancer 2026;73(7):e70340. Mixed-methods study of 395 children receiving cancer care at the Uganda Cancer Institute; 69.9% used traditional or complementary medicine, most often spiritual practices and herbs. Single national center. Abstract read.
- 604Leng M, Downing J, Purewal G, et al.
Evaluation of the integration of palliative care in a fragile setting amongst host and refugee communities: Using consecutive rapid participatory appraisals. Palliat Med 2024;38(8):818-829. Two rapid participatory appraisals four years apart evaluating palliative care integration in Adjumani District, where refugees and hosts live side by side; 104 key informants; evaluators linked to the integration work. Abstract read.
- 605Song N, Aduro-Agema A, Namisango E, et al.
"…I feel like I am just staying here waiting for death": A qualitative study of the lived experiences of people with advanced illness in refugee settlements in Uganda. PLOS Glob Public Health 2025;5(12):e0005541. Qualitative interviews with 44 refugees with advanced illness in three Ugandan refugee settlements on their illness and care experiences. Abstract read.
- 606Namisango E, Aduro A, Goodman W, et al.
Feasibility and Acceptability of mPallCarea Digital Health Intervention for People Living With Advanced Cancer in a Refugee Settlement in Uganda: Mixed Methods Study. JMIR Mhealth Uhealth 2026;14:e73483. Six-week uncontrolled feasibility study of a mobile palliative care app with 32 people with advanced cancer in Bidibidi Refugee Settlement; developer-linked team. Abstract read.