National palliative care capacities around the world: Results from the World Health Organization Noncommunicable Disease Country Capacity Survey

Sharkey, Lee; Loring, Belinda; Cowan, Melanie J.; Riley, Leanne M; Krakauer, Eric L.

doi:10.1177/0269216317716060

Cited by 52 publications

(46 citation statements)

References 15 publications

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“…Explicit national policies for palliative care provide a necessary foundation for palliative care development, but successful policies require universal essential palliative medicine accessibility, routine education of health care workers in palliative care, and widespread implementation. 13 Such actions are also likely to require a costed national plan, with political and financial commitment over several decades. 6 A key question is how to influence the development and implementation of policy, and where, for global activists, the balance of their limited resources should rest.…”

Section: Discussionmentioning

confidence: 99%

Palliative Care in Public Policy: Results from a Global Survey

Clelland

Steijn

Whitelaw

et al. 2020

Palliative Medicine Reports

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Background: Public policy has been a foundational component of the World Health Organization public health model for palliative care development since 1990. There is, however, limited evidence on the existence and character of palliative care policy at the country level. Objective: To identify, report on, and map the presence of national palliative care strategies, plans, legislation, and dedicated government resources in 198 countries. Design: An online survey generated 2017 data on indicators of national policy for palliative care. Subjects: In-country experts on palliative care. Measurements: The survey included specific questions on the existence and status of national strategies or plans, recognition of palliative care in national law, and dedicated government support. Results: Fifty-five countries have a national strategy or plan for palliative care of some sort, though levels of implementation vary. Forty-seven countries have some reference to palliative care in national law, and 24 have some form of stand-alone national law on palliative care provision or recognize it as a right in the constitution. Sixty-six countries have a dedicated section within government with responsibility for palliative care. Conclusions: There is a long way to go before palliative care around the world is universally supported by public policy intentions that will support its required development.

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Section: Discussionmentioning

confidence: 99%

Palliative Care in Public Policy: Results from a Global Survey

Clelland

Steijn

Whitelaw

et al. 2020

Palliative Medicine Reports

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“…We describe these limitations and the improvements in detail in the study protocol. 14 There is a debate in the literature 7,14 about the merits of using palliative care specialists or government sources to obtain the kind of data we report here. Both have their limitations.…”

Section: Limitationsmentioning

confidence: 99%

“…6 Two WHO studies have thrown some light on palliative care development globally. A 2015 survey 7 was able to report that 37% of countries had an operational national policy for noncommunicable diseases which included palliative care; palliative care services were financially disadvantaged compared to other noncommunicable disease services; and a large country-income gradient existed for palliative care funding, for oral morphine availability, and the integration of palliative care at the primary levels of the health system. A 2017 survey 8 reported that 68% of countries had some form of funding for palliative care and approximately one-third of countries responded that palliative care was generally available in both primary health care facilities (35%) and community or home-based care (37%).…”

Section: Introductionmentioning

confidence: 99%

Mapping Levels of Palliative Care Development in 198 Countries: The Situation in 2017

Clark

Clelland

Garralda

et al. 2020

Journal of Pain and Symptom Management

217

164

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Context. Palliative care is gaining ground globally and is endorsed in high-level policy commitments, but service provision, supporting policies, education, and funding are incommensurate with rapidly growing needs. Objectives. The objective of this study was to describe current levels of global palliative care development and report on changes since 2006. Methods. An online survey of experts in 198 countries generated 2017 data on 10 indicators of palliative care provision, fitted to six categories of development. Factor analysis and discriminant analysis showed the validity of the categorization. Spearman correlation analyses assessed the relationship with World Bank Income Level (WBIL), Human Development Index (HDI), and Universal Health Coverage (UHC). Results. Numbers (percentages) of countries in each development category were as follows: 1) no known palliative care activity, 47 (24%); 2) capacity-building, 13 (7%); 3a) isolated provision, 65 (33%); 3b) generalized provision, 22 (11%); 4a) preliminary integration into mainstream provision, 21 (11%); 4b) advanced integration, 30 (15%). Development levels were significantly associated with WBIL (r S ¼ 0.4785), UHC (r S ¼ 0.5558), and HDI (r S ¼ 0.5426) with P < 0.001. Net improvement between 2006 and 2017 saw 32 fewer countries in Categories 1/2, 16 more countries in 3a/3b, and 17 more countries in 4a/4b. Conclusion. Palliative care at the highest level of provision is available for only 14% of the global population and is concentrated in European countries. An 87% global increase in serious health-related suffering amenable to palliative care interventions is predicted by 2060. With an increasing need, palliative care is not reaching the levels required by at least half of the global population.

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“…There is growing engagement from policy makers, researchers and activists in the development of palliative and end-of-life care in a global context [5][6][7][8] . This builds on discussions about how palliative care began as a social and medical movement in the West and over time expanded its scope and influence 9 .…”

Section: Introductionmentioning

confidence: 99%

Recalibrating the ‘world map’ of palliative care development

Centeno¹,

Garralda²,

Connor³

et al. 2019

Wellcome Open Res

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Background: Despite growing interest from policy makers, researchers and activists in the global development of palliative care, there is still little science to underpin it. This study presents the methods deployed in the creation of a ‘world map’ of palliative care development. Building on two previous iterations, with improved rigour and taking into account reviewers’ feedback, the aim of this recalibrated version of the study is to determine the level of palliative care development in 198 United Nations recognised countries in 2017, whilst ensuring comparability with previous versions. We present methods of data collection and analysis. Methods and analysis: Primary data on the level of palliative care development in 2017 was collected from in-country experts through an online questionnaire and, where required, supplemented by published documentary sources and grey literature. Data relating to the total population of each country as well as per capita opioid consumption were derived from independent sources. Data analysis was conducted according to a new scoring system and algorithm developed by the research team. Ethics and dissemination: The study was approved by the University of Glasgow College of Social Sciences Research Ethics Committee. Findings of the study will be disseminated in peer-reviewed journals, as a contribution to the second edition of the Global Atlas of Palliative Care at the End-of-Life, and via social media, including the Glasgow End of Life Studies Group blog and the project website. Limitations of the study: There are potential biases associated with self-reporting by key in-country experts. In some countries, the identified key expert failed to complete the questionnaire in whole or part and data limitations were potentially compounded by language restrictions, as questionnaires were available only in three European languages. The study relied in part on data from independent sources, the accuracy of these data could not be verified.

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National palliative care capacities around the world: Results from the World Health Organization Noncommunicable Disease Country Capacity Survey

Abstract: Palliative care for noncommunicable disease patients must be strengthened in a majority of countries. These data provide a baseline for trend measurement of official country-level and global palliative care development. A repeat assessment is taking place in the first half of 2017.

Cited by 52 publications

References 15 publications

Palliative Care in Public Policy: Results from a Global Survey

Palliative Care in Public Policy: Results from a Global Survey

Mapping Levels of Palliative Care Development in 198 Countries: The Situation in 2017

Recalibrating the ‘world map’ of palliative care development

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