The second edition of the WHPCA Global Atlas of Palliative Care was launched during World Hospice & Pal
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liative 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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Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoida
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ble 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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As countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services place attention on quality of
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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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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
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suffering for many.
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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
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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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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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This toolkit has been written to empower health workers in resource-poor settings to integrate palliative care into the work they are doing by grafting the missing elements of
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care onto what is already in place. The WHPCA, Hospice UK and Palliative Care Works have led this updating of the Palliative Care Toolkit published in 2008 to reflect new knowledge and practice
The Manual is available in various languages: English, Swahili, Bengali, French, Georgian, Portuguese, Spanish, Vietnamese, Russian,
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Journal of Palliative Medicine Volume 21, Number 10, 2018
DOI: 10.1089/jpm.2018.0248ad
Palliative care has been shown to provide significant and diverse benefits for patients with serious, complex,or life-limiting health problem.
Jamison DT, Gelband H, Horton S, Jha P, Laxminarayan R
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, Mock CN, Nugent R., editors. Disease Control Priorities, 3rd Edition,
Volume 9: Improving Health and Reducing Poverty. Washington DC: World Bank 2018. doi:10.1596/978-1-4648-0527-1
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A handbook for leaders and managers
This document outlines why and how nurses and midwives are important, not only for individual health optimization but also to achieve the thematic priorities of For the Future. More specifically, it provides case studies to showcase the amazing work that nurses and midwives across the Region are doi
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ng to improve health. The document also provides future policy directions to strengthen the scope and leadership of the nursing and midwifery workforce, alongside actions to accelerate investment in their education, skills and employment.
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This volume presents the complex patterns of cancer incidence and death around the world and evidence on effective 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 alte
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rnative cancer care packages that are cost-effective and suited to low-resource settings.
Disease Control Priorities, Third Edition: Volume 3
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This report includes six case studies from 12 individuals with lived experience of diverse health conditions. These case studies explore the topics of power dynamics and power reorientation towards individuals with lived experience; informed decision-making and health literacy; community engagement
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across broader health networks and health systems; lived experience as evidence and expertise; exclusion and the importance of involving groups that are marginalized; and advocacy and human rights.
It is the first publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives,inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
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There is a substantial and ever-increasing unmet need for rehabilitation worldwide, which is particularly profound in low- and middle
-income countries. The availability of accessible and affordable rehabilitation is necessary for many people with
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health conditions to remain as independent as possible, to participate in education, to be economically productive, and fulfil meaningful life roles.
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Cryptococcal disease is one of the most common opportunistic infections among people living with advanced HIV disease and is a major contributor to severe illness, morbidity, and mortality, particularly in sub-Saharan Africa.
These guidelines update the recommendations that were first released i
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n 2018 on diagnosing, preventing, and managing cryptococcal disease. In response to important new evidence that became available in 2021, these new guidelines strongly recommend a single high dose of liposomal amphotericin B as part of the preferred induction regimen for the treatment of cryptococcal meningitis in people living with HIV. This simplified regimen - a single high dose of liposomal amphotericin B paired with other standard medicines (flucytosine and fluconazole) - is as effective as the previous WHO standard of care, with the benefits of lower toxicity and fewer monitoring demands.
The objective of these guidelines is to provide updated, evidence-informed recommendations for treating adults, adolescents and children living with HIV who have cryptococcal disease. These guidelines are aimed at HIV programme managers, policymakers, national treatment advisory boards, implementing partners and health-care professionals providing care for people living with HIV in resource-limited settings with a high burden of cryptococcal disease.
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Pan African Medical Journal 2017;27:215. doi: 10.11604/pamj.2017.27.215.12994