Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoidable suffering on a massive scale due to lack of acc
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ess to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic palliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
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This publication aims to provide examples of better palliative care practices for older people to help those involved in planning and supporting care-oriented services most appropriately a
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nd effectively. Examples have been identifi ed from literature searches and from an international call for examples through various organizations, including the European Association of Palliative Care and the European Union Geriatric Medicine Society. Some examples consider how to improve aspects within the whole health system; specifi c smaller examples consider how to improve palliative care education, support in the community, in hospitals or for specifi c groups of people, such as people in nursing homes and people with dementia and their families. Some examples await rigorous evaluation of effectiveness, and more research is needed in this fi eld, especially the cost–effectiveness and generalizability of these initiatives.
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People younger than 20 years comprise 35% of the global population and 40% of the global population of least-developed nations. The number of children - neonates, infants, children, and adolescents up to 19 years of age - who need pediatric palliative care
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(PPC) each year may be as high as 21 million. Another study found that almost 2.5 million children die each year with serious health related suffering and that more than 98% of these children are in low- and middle-income countries (LMICs) (3). While estimates differ, there is no doubt that there is an enormous need for prevention and relief of suffering among children - for PPC.
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Globally, approximately 56.8 million people are in need of palliative care
services; 78% of them living in low and middle-income country yet only
about 12% have their needs being met causing great suffering for many.
The knowledge guide is the second publication in the Self-care competency framework to support health and care workers.
This describes how health and c
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are workers can apply each of the 10 competency standards in their work, detailing the necessary knowledge, skills and attitudes that underpin the required behaviours.
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This publication summarizes the facilitators and barriers that will be encountered in the deinstitutionalization process and identifies useful and proven interventions in Latin American and Caribbean countries. Four areas of work are identified with the respective guidelines or suggestions for actio
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n, which should provide an operational guide for countries that are restructuring mental health services and moving toward the deinstitutionalization of psychiatric care.
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Tuberculosis (TB) is, and should be, a curable disease; however, each year significant numbers of patients acquire or develop drug-resistant TB, which has a much lower cure rate. Patients with drug-resistant TB have a high prevalence of symptoms; hence, staff caring for these patients should h
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ave some familiarity with palliative care, so that general palliative care principles are available to all patients. The timely identification, and addressing, of adverse events occurring during the treatment course is considered as general palliative care for those receiving curative treatment. This publication summarizes the general palliative care approach, which is recommended for use in settings and services that occasionally treat palliative care patients, but do not provide palliative care as the main focus of their work. The review focuses on 18 high TB priority countries of the WHO European Region.
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The standards define 10 key competencies for health and care workers to support self-care in their clinical practice as well as the specific, measurable behaviours that demonstrate those competencie
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s, focusing on people-centredness; decision-making; effective communication; collaboration; evidence-informed practice, and personal conduct.
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Primary care - Putting people first: This chapter describes how primary care brings promotion and prevention, cure and care together in a safe, eff
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ective and socially productive way at the interface between the population and the health system.
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Humanitarian emergencies and crises (Humanitarian emergencies and crises) are large-scale events that may result in the breakdown of health care systems and society, forced displacement, death, and physical, psychological, social and spiritual suffe
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ring on a massive scale. Current responses to Humanitarian emergencies and crises rightfully focus on saving lives, but for both ethical and medical reasons, the prevention and relief of pain, as well as other physical and psychological symptoms, social and spiritual distress, also are imperative. Therefore, palliative care, should be integrated into responses to Humanitarian emergencies and crises. The principles of humanitarianism and impartiality require that all patients receive care and should never be abandoned for any reason, even if they are dying. Thus, there is significant overlap in the principles and mission of palliative care and humanitarianism: relief of suffering; respect for the dignity of all people; support for basic needs; and accompaniment during the most difficult of times
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Submission by the WHO Collaborating Centre on training and policy on opioid availability and WHO collaborating Centre for community participation in palliative care and long term care To the Indian
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Nursing Council for consideration to be included in the Undergraduate Nursing education curriculum
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A guide to Primary Health Care Facility Supervision
This report explores community-focused change initiatives in the financing, organization, and delivery of mental health services in Peru from 2013 to 2016. It examines the national dimension of reforms but focuses above all on implementation and results in the economically fragile district of Caraba
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yllo, in northern Lima.
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