Background Evidence-based approach to the care at the end of life will decrease the danger placed on traditional and familiar policies in hospitals of Sub-Saharan Africa. Palliative care has different characteristics within Africa, there are diverse attitudes to palliative and end of life care informed by multiple meanings and traditions. Although there is insufficient information documented on palliative and end of life care provision in Nigeria and other Sub-Saharan African countries, and there is only weak evidence upon which to build policy and practice development. Nurses and family carers are faced with different challenges when providing care to patients at the end of life. Therefore, it became imperative to explore the factors perceived to promote care at the end of life from the perspective of nurses, patients, and family carers.

Method A qualitative ethnographic case study design was employed for the study. Participant observations consisting of 188 hours of observation, and semi-structured interviews with 40 participants (nurses-14, patients-12, and family carers-14) were used as tools for data collection. Data analysis follows an inductive thematic approach using NVivo 11 qualitative data management programme.

Findings Six overarching themes emerged: Enhanced communication skills, Increase drug supply, improve manpower, reward or incentives, training of staff, and improve logistics supplies.

Conclusion Basically, these factors were directly related to the poor managerial processes and hospital’s policies. If the hospital management increases drug supply, improve manpower, revive decayed infrastructure, improve logistics supplies, provide reward or incentives to staff, and encourages staff training and development, certainly the quality of palliative and end of life care will be improved.