From Comfort to Prevention: Uganda’s New Approach to Hospice Care

A clinician gently holds a patient's hand, representing hospice's focus on dignity and comfort at the end of life.

When we hear the word “hospice,” some may intuitively visualize death, grieving, finality, and the act of providing comfort in anticipation of loss. By definition, hospice serves as a specific type of palliative care provided to individuals with terminal illnesses, focusing on dignity and quality of life. To fully understand how hospice has continued to evolve today, it is helpful to first consider how the modern movement began.  

While the origins of hospice and home care trace back to ancient civilizations, ideas of modern hospice as we know it began in England during the late 1950s and were officially implemented by Dame Cicely Saunders after initiating St. Christopher’s Hospice in 1967. Defying traditional models of medicine, Saunders’s vision prioritized support and comfort over curative treatments. Today, we are seeing yet another transformation of hospice and its purpose in the Global South within Uganda.

Counter to Western understanding of hospice—where models focus primarily on alleviating pain—Uganda’s Rays of Hope Hospice Jinja noticed that many women with cervical cancer, even when administered liquid morphine and other pain medications, passed away amid immense suffering. Estimates reveal that approximately 4,607 deaths per year arise from cervical cancer in Uganda, and 80% of these cases are discovered in their late stages. 

The organization recognized that true compassion requires not only easing suffering at the end of life, but also preventing avoidable suffering earlier on in the disease trajectory. In recent years, Rays of Hope Hospice Jinja has transformed and expanded its end-of-life care model into a preventative system, offering cervical and breast cancer examinations in Uganda’s Busoga region. Here, they encourage hope and healing at the end of life while simultaneously addressing cancer with prevention, early diagnosis, and treatment. By the end of 2025, they had screened 12,782 women for breast cancer and 16,003 women for cervical cancer. Rays of Hope Hospice Jinja targeted this problem and took action counter to what one would expect from the scope of a typical hospice, emphasizing that treating for pain alone is not enough. 

With the additional consideration that HPV causes more than nine out of every ten cases of cervical cancer, Rays of Hope Hospice Jinja addresses the HPV crisis by assisting the district health department in administering vaccinations to 47,000 girls–a distinct approach from hospices in the West. In expanding these preventative measures, Rays of Hope Jinja has doubled its staff and palliative care patients, proving that collaboration between hospice models of medicine and preventative care is not only possible but highly productive. 

The success of this integrated model raises important questions about how other healthcare systems structure palliative care. The first-ever global ranking of palliative care, published in November 2025, indicated that despite Uganda’s limited resources, the country stands out as a regional example of advanced palliative care development, holding a high global development score (GDS) of 3,321. An “advanced” level of development is the highest classification on the researchers’ scale, representing countries with sustained policy implementation and high measures of integration, access, coverage, and governance. Scores were assigned based on 14 indicators ranging from health policies to education and training. Uganda remains the only country scored as “advanced” in Africa and is ranked first on the continent. As a comparison, the United States ranks third in its region with an advanced GDS of 3,357, trailing Uruguay and Costa Rica in the Americas. 

The stark GDS similarity between the United States and Uganda, despite vast differences in resources between the two countries, raises important questions about the United States’ model of palliative care. Modern hospices, especially within the United States, should consider integrating preventative measures alongside end-of-life care, as demonstrated by Rays of Hope Hospice Jinja. In doing so, it challenges the traditional assumption that hospice care must remain separate from broader public health efforts.

While Rays of Hope Hospice Jinja has set a positive example for other countries to follow, it should also be noted that Uganda’s palliative care system has gaps. In October 2024, the Ugandan Ministry of Health found that out of 500,000 Ugandans needing palliative care, only 11% were receiving it. While progress still needs to be made, the country undeniably exemplifies what it takes to be strategic and proactive in end-of-life care support. Collaboration across different medical practices and health systems is not only possible but profoundly beneficial, demonstrating that progress in palliative care does not have to be constrained by resource limitations or public health crises.

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Curated Lifestyle, Unsplash+ License, via Unsplash