The intersection of food insecurity and health for rural Malawian women at the end of life

Int J Palliat Nurs. 2020 Oct 2;26(7):372-382. doi: 10.12968/ijpn.2020.26.7.372.

Abstract

Background: One of the poorest countries in the world, Malawi's palliative care system is under-resourced, and one-third of the population is food-insecure.

Aims: This study describes the lived experience of female palliative care patients, and their caregivers, and aimed to: (1) analyse their physical, spiritual and mental health needs; and (2) analyse best palliative nursing practice for patients at the end of life. An unexpected finding was the impact of food insecurity on the women and their caregivers.

Methods: We conducted interviews with 26 women who at the end of life and 14 of their caregivers. All were participating in a community palliative care programme offered by an AIDS support organisation in Kasungu, Malawi. We used deductive qualitative analysis to organise identified themes using the four pillars of food security: availability, access, utilisation and stability.

Findings: All study participants experienced challenges with food security.

Conclusions: We offer policy recommendations for palliative care nurses, and other allied health professionals.

Keywords: End-of-life care; Food insecurity; Malawi; Nutrition; Palliative nursing.

MeSH terms

  • Caregivers
  • Death
  • Female
  • Food Insecurity*
  • Hospice and Palliative Care Nursing
  • Humans
  • Malawi
  • Needs Assessment
  • Palliative Care*
  • Qualitative Research
  • Rural Population*
  • Terminal Care*