Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health
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care (1). Currently, there is avoidable suffering on a massive scale due to lack of access 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 sup
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porting care-oriented services most appropriately and 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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The second edition of the WHPCA Global Atlas of Palliative Care was launched during World Hospice & Palliative
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Care Day 10 October. The Atlas is an update of the original WHPCA/WHO Global Atlas of Palliative care at the end of life published in 2014. It is full of useful facts and figures to support palliative care advocacy and development. In this edition we have switched from using the WHO methodology for need for palliative care to the evolving Lancet Commission on Palliative Care and Pain Relief methodology. As a result the number of people needing palliative care has gone from 40 million per year to almost 57 million and more accurately reflects the need for palliative care globally models of palliative care worldwide? What resources are devoted to palliative care? What is the way forward?
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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
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up to 19 years of age - who need pediatric palliative care (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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As countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services pla
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ce attention on quality of care, with action needed across all domains of quality health services: effectiveness, safety, people-centredness, timeliness, equity, integration and efficiency. Providing compassionate, dignified and people-centred palliative care is an ethical responsibility of health systems.
This document provides a practical resource to support implementation of sustainable improvements in the quality of palliative care. It describes approaches to quality policy, strategy and planning for palliative care programmes and services, presents learning on quality of care arising from palliative care programmes, and offers considerations on measurement of quality palliative care services at all levels of the health system. The document also highlights relevant WHO resources available that further support the development of quality palliative care services.
The audience for this document is a general one that includes policy-makers, palliative care service planners, managers, practitioners and health care providers at all levels.
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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 sy
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stems and society, forced displacement, death, and physical, psychological, social and spiritual suffering 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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One of the main aims of the WHO Global Initiative for Childhood Cancer and the CureAll Americas framework is to strengthen centers of excellence and
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promote the training of the health workforce, especially pediatric oncology nurses, specialized in nursing care for children and adolescents with cancer and their families. These health personnel provide compassionate, non traumatic, complex, continuous, ethical, conscious patient- and family-centered care in order to meet the physical, emotional, psychosocial, and cultural needs of the people involved. This publication is aimed at health administration teams, hospital management teams, and professional pediatric oncology nursing groups. Its objective is to identify, systematize, and consolidate available evidence on the scope of pediatric oncology nursing practice in Latin America and the Caribbean based on core competencies, in order to incorporate them into clinical practice, teaching, and research. The preparation process included a systematic review aimed at finding the best evidence on this subject. Patient- and family centered care and the conceptual model of competencies for teenagers and young adults with cancer, developed by the Teenage Cancer Trust with the support of the Royal College of Nursing, were the theoretical foundations supporting the systematization of recommendations.
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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
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about 12% have their needs being met causing great suffering for many.
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The APCA Atlas provides the most up-to-date information of palliative care development in nearly all countries in Africa, using indicators derived, rated,
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and chosen by in-country African experts followed by a thorough Delphi consensus process with a panel of international experts on palliative care indicators
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This volume presents the complex patterns of cancer incidence and death around the world and evidence on effective
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and cost-effective ways to control cancers. The Disease Control Priorities Volume 3 evaluation of cancer will indicate where cancer treatment is ineffective and wasteful, and offer alternative cancer care packages that are cost-effective and suited to low-resource settings.
Disease Control Priorities, Third Edition: Volume 3
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The Atlas of Palliative Care in the Eastern Mediterranean Region is the first systematic attempt to assess the status of resources, activities, and
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needs of palliative care in the region. It provides a comparative picture of the current state of palliative care in simple and clear graphics, utilising texts, tables, figures and maps that reproduce information given by national palliative care leaders in the Eastern Mediterranean. This information is essential for the appropriate planning of the development of palliative care for this region.
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Cancer centres are a major resource in ensuring a comprehensive approach to cancer treatment and
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its planning. As part of a new roadmap developed by WHO and IAEA to help countries design national cancer control programmes, this publication proposes a framework to develop a cancer centre and/or to strengthen the provision of services in an existing cancer centre. The publication provides the features of multidisciplinary cancer care and details the infrastructure, human resources and equipment for different services. This framework is expected to be used as a guide to implementation, taking into consideration the local context and resources.
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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 sympto
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ms; hence, staff caring for these patients should have 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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Cervical cancer, along with maternal deaths, has been identified as a national priority in
South Africa as well as other Sub-Saharan African countries. Cervical cancer is the
second most common
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cancer among women in South Africa, after breast cancer. Due
to limited access to prevention, early diagnosis and treatment, cervical cancer is often
fatal.
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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 pall
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iative care and long term care To the Indian Nursing Council for consideration to be included in the Undergraduate Nursing education curriculum
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