INTRODUCTION: East African Community (EAC) partner states face a dual burden of HIV/AIDS and rapidly rising non-communicable diseases (NCDs), yet access to palliative care, including basic pain relief, remains limited, and sociocultural dynamics strongly shape how such care is understood and accepted. This review synthesized the sociocultural, spiritual, and clinical palliative care needs of patients with advanced NCDs across the eight EAC partner states, and to examine how their structural support needs differ from those of people living with HIV/AIDS.
METHODS: A structured narrative synthesis was conducted. PubMed, Scopus, and Web of Science were searched using terms combining geographic and palliative care concepts; records were screened against Population–Concept–Context criteria, and 21 core publications were thematically synthesized, with detailed data extraction performed on ten primary empirical studies.
RESULTS: Three themes emerged: (1) severe, region-wide deficits in pain and symptom management compounded by restrictive opioid regulation; (2) pervasive communication taboos and prognostic silence that obstruct disclosure and future planning; and (3) the centrality of spirituality, religious networks, and indigenous belief systems, which providers are often unprepared to engage. NCD cohorts reported acute informational deficits, whereas HIV/AIDS cohorts historically reported predominantly structural and financial needs.
CONCLUSION: Culturally grounded communication strategies, spiritual-care competence, and equitable opioid access are regional priorities; localized primary research is urgently needed in Burundi, Somalia, South Sudan, and the Democratic Republic of the Congo.
