Source: WHO
Context:
With roughly 20% of the world's population, India bears a disproportionate burden of noncommunicable diseases. Cancer, diabetes, hypertension, and respiratory disorders are all on the rise, necessitating the use of palliative care.
About Palliative Care:
Palliative care is a form of medical care that prioritizes improving the quality of life for individuals with serious illnesses.
It focuses on preventing suffering and identifying patients who may be receiving excessive medical treatments that do not enhance their quality of life.
Key Points:
Palliative care addresses the physical, psychological, spiritual, and social needs of individuals with conditions such as heart failure, kidney failure, neurological diseases, and cancer.
The World Health Organization (WHO) estimates that around 40 million people require palliative care annually, with 78% of them residing in low- and middle-income countries.
Currently, only approximately 14% of those in need of palliative care worldwide actually receive it.
The WHO has recognized palliative care as an integral part of comprehensive services for noncommunicable diseases (NCDs) through the Global Action Plan for the Prevention and Control of NCDs 2013-2020.
In 2019, the World Health Assembly extended the WHO Global Action Plan for the prevention and control of NCDs from 2013-2020 to 2030.
Importance and Impact:
Palliative care is essential for improving the well-being and comfort of individuals facing serious illnesses.
It ensures that medical interventions align with the patient’s goals and values, preventing unnecessary treatments and financial burdens on families.
By acknowledging palliative care as a human right, it underscores the importance of providing comprehensive care to those in need.
Expanding access to palliative care is crucial to meet the global demand and address disparities in its availability.
The Status of Palliative Care in India:
Availability:
Palliative care in India is primarily concentrated in urban areas and tertiary healthcare facilities.
Only a small percentage, estimated to be 1-2%, of the 7-10 million people in India who require palliative care have access to it.
Implementation and Funding:
The National Palliative Care Program does not have a separate allocated budget.
Palliative care is included as part of the “Mission Flexipool” under the National Health Mission (NHM).
National Health Programs:
The National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS) was launched in 2010 and later revised as the National Programme for Prevention & Control of Non-Communicable Diseases (NP-NCD).
It aims to address the growing burden of non-communicable diseases in India by providing comprehensive care across all levels of healthcare.
Challenges in the Status of Palliative Care in India:
Lack of Awareness and Understanding:
There is a general lack of awareness and understanding about palliative care among the public and healthcare professionals in India.
Many people are unaware of the benefits of palliative care and may confuse it with end-of-life care.
Shortage of Dedicated Facilities and Trained Professionals:
India faces a shortage of dedicated palliative care centers, hospices, and trained healthcare professionals.
This limits the availability of palliative care services, especially in rural and remote areas.
Inadequate Training in Palliative Care:
Healthcare professionals, including doctors, nurses, and caregivers, often lack sufficient training in palliative care.
This hinders their ability to provide effective pain and symptom management, as well as psychosocial support to patients.
Neglect of Pediatric Palliative Care:
Pediatric palliative care has been neglected for a long time in India.
Many children facing moderate to severe suffering, often due to conditions like cancer, birth defects, or neurological disorders, do not receive adequate palliative care.
Inadequate Focus in National Health Programs:
The revised operational guidelines of the National Programme for Prevention & Control of Non-Communicable Diseases (NP-NCD) have not adequately addressed the need for palliative care.
The implementation of palliative care services under NP-NCD has been slow and uneven, leading to limited progress in expanding access to care.
About Non-communicable diseases:
Non-communicable diseases (NCDs), also known as chronic diseases, are medical conditions that are not caused by infectious agents and cannot be transmitted from one person to another.
NCDs are generally long-lasting and progress slowly over time.
They are often associated with lifestyle factors, environmental influences, and genetic predisposition.
Common examples of non-communicable diseases include:
Cardiovascular diseases: These include conditions such as heart disease, stroke, and hypertension (high blood pressure). They are usually related to factors like poor diet, physical inactivity, smoking, and excessive alcohol consumption.
Cancer: Non-communicable diseases include various types of cancer, such as lung cancer, breast cancer, colorectal cancer, and prostate cancer. Risk factors for cancer can include tobacco use, exposure to certain chemicals or radiation, unhealthy diet, and family history.
Chronic respiratory diseases: Conditions like chronic obstructive pulmonary disease (COPD), asthma, and occupational lung diseases fall under this category. Factors such as tobacco smoke, indoor and outdoor air pollution, and occupational hazards contribute to the development of these diseases.
Diabetes: Diabetes is a metabolic disorder characterized by high blood sugar levels. It can be of two main types: type 1 diabetes, which is usually diagnosed in childhood, and type 2 diabetes, which is typically associated with lifestyle factors such as obesity, physical inactivity, and unhealthy diet.
Mental health disorders: While mental health conditions can have various causes, some are considered non-communicable diseases. These include depression, anxiety disorders, bipolar disorder, and schizophrenia.
Chronic kidney disease: This refers to long-term damage to the kidneys, leading to reduced kidney function over time. Diabetes, hypertension, and certain genetic factors can contribute to the development of chronic kidney disease.
