Palliative Care

• 19 Oct 2023

For Prelims: Palliative care, World Health Organization, Noncommunicable diseases, National Health Mission, Telemedicine

For Mains: Issues Related to Healthcare in India, Significance of Palliative Care.

Source: TH

Why in News?

A recent study has shed light on the overwhelming financial burden faced by patients grappling with serious illnesses.

• As the cost of treating life-limiting illnesses pushes individuals into poverty, palliative care becomes essential to address this critical issue and advocate for holistic patient-centered care.

What is Palliative Care?

• About:
  • Palliative care is a specialized approach to healthcare that focuses on improving the quality of life and providing comprehensive support to individuals facing serious illnesses or life-limiting conditions.
    • It is not about curing the disease but rather about addressing the physical, emotional, social needs of the patient.
    • It differs from other medical specialties as it addresses not only physical health but also social and economic realities.
• Significance:
  • According to the World Health Organization (WHO), palliative care is explicitly recognized under the human right to health.
    • It recognizes that palliative care is part of the comprehensive services required for noncommunicable diseases (NCDs) through the Global Action Plan for the Prevention and Control of NCDs 2013–2020.
  • Early initiation of palliative care in advanced disease stages can reduce healthcare expenditure by up to 25%.
    • Also, palliative care emphasizes vocational rehabilitation and social reintegration, enabling patients and families to earn a living and maintain their dignity.

Note

WHO estimates that 56.8 million people need palliative care each year, including 25.7 million in the last year of life. In India, it's estimated that 5.4 million people need palliative care each year.

• Only about 14% of people who need palliative care receive it.

• Related Issues in India:
  • Inadequate Investment in Healthcare: Inadequate investment in India's healthcare system, including the insufficient fulfillment of basic infrastructure needs, has resulted in a backlog of palliative care services, limiting their availability and accessibility for patients with life-limiting illnesses.
    • Also, with only 1.35% of the GDP allocated to government health services (2019-20), patients bear most of the healthcare costs which leaves them at risk of bankruptcy, decreased satisfaction with treatment, delayed medical care, poor quality of life, and lower survival rates.
  • Limited Awareness and Understanding:
    • Among Patients and Families: Many individuals and their families are unaware of what palliative care entails and may associate it with end-of-life care only, leading to delayed or inadequate utilization.
      • Also, most insurance schemes in India do not cover palliative care, further limiting its accessibility.
    • Among Healthcare Providers: Even many healthcare professionals lack a clear understanding of palliative care, which result in insufficient referrals or integration into treatment plans.
  • Heterogeneous Healthcare Infrastructure: The healthcare infrastructure varies widely in India, with advanced healthcare facilities concentrated in urban areas and limited access to palliative care services in rural and remote regions.
    • However, even in urban areas, as palliative care does not generate revenue but saves costs, it is often neglected in the increasingly privatized Indian healthcare system.
• Palliative Care Programme in India:
  • While there is no dedicated budget for the National Palliative Care Program in India, it is included within the 'Mission Flexipool' under the National Health Mission (NHM).
  • Additionally, the National Program for Prevention & Control of Non-Communicable Diseases (NP-NCD) launched in 2010 focuses on addressing the rising burden of non-communicable diseases by offering comprehensive healthcare services spanning promotive, preventive, and curative care across all levels of healthcare.

Way Forward

• Policy and Regulatory Framework: There is a need to develop and implement clear, uniform palliative care policies and regulations at both the national and state levels to guide the integration of palliative care services into the healthcare system.
• Public Awareness: Launching comprehensive public awareness campaigns to educate both patients and healthcare providers about the benefits and scope of palliative care, dispelling myths and stigma associated with it.
  • Also, Integrating palliative care training into the curriculum of healthcare professionals, ensuring that medical schools, nursing programs, and other training institutions offer courses and practical experience in palliative care.
• Funding and Resource Allocation: Allocating specific and sufficient resources to the National Program for Palliative Care and ensuring that insurance schemes cover palliative care services.
• Leveraging Technology: Leveraging emerging technologies such as telemedicine, mobile health apps, and wearable devices to provide remote palliative care consultations and monitoring.