Integrating compassion, prioritising palliative care, Pg6

Context:

• Despite a growing burden of terminal and chronic illnesses, palliative care remains severely underutilised and underfunded in India, necessitating urgent systemic integration and policy focus.

Key Highlights:

• Palliative care is specialised medical care aimed at alleviating suffering and improving quality of life for patients with serious illnesses, unlike curative treatment.
• Only 1–2% of the 7–10 million Indians in need annually receive palliative care.
• WHO estimates that 78% of people needing palliative care live in low- and middle-income countries, yet only 14% get access.
• National Health Policy 2017 included palliative care, but delivery remains uneven.
• India's doctor-population ratio meets WHO standards, but palliative care specialists are scarce.
• Challenges include lack of trained personnel, low public awareness, and inadequate infrastructure.
• Task-shifting and targeted training of nursing and allied health professionals is proposed.

Detailed Insights:

• India faces a dual burden of non-communicable diseases and insufficient support infrastructure.
• Despite policy recognition in 2017, actual integration into primary and tertiary care remains incomplete, particularly in rural and economically weaker regions.
• There's a significant skills gap among general doctors due to inadequate exposure to palliative medicine during MBBS education.
• Task-shifting and use of India’s large pool of 34.33 lakh nursing staff and 13 lakh allied health workers can decentralise delivery.
• Public awareness campaigns are essential to demystify palliative care and broaden its acceptance as more than just end-of-life care.
• The U.S. model offers insights into robust funding, insurance-linked access, and institutionalised hospice systems which India can adapt suitably.
• Collaboration with NGOs and private sector, research on cost-effective models, and inclusion in insurance schemes are essential next steps.

Key Concepts Involved:

• Palliative Care: Medical care that focuses on relief from symptoms, pain, and stress of serious illness, regardless of diagnosis or treatment stage.
• Task-Shifting: Redistribution of tasks among health workforce teams; from specialists to trained non-specialists to improve service coverage.
• Non-Communicable Diseases (NCDs): Chronic diseases like diabetes, and cardiovascular conditions not passed from person to person.

Mains Mock Question:

"Palliative care is not just about dying well but living well until the end." Examine the gaps in India’s palliative care framework and suggest policy measures for its integration into the healthcare system.