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Around 40 million individuals worldwide require palliative care, with nearly 69 percent of individuals being over the age of 60. Over three-quarters of those needing palliative care are from low- and middle-income countries (LMICs). In these regions, palliative care is still developing and is primarily limited to urban areas.
A study conducted by Aregay at al., (1) examined 30 research papers published between 1990 and 2019 that describe strategies used by LMICs to develop palliative care in rural areas. Data from the included papers was analyzed using a public health model as a framework to define strategies for creating palliative care in rural areas, which covered policy, drug availability, education, and implementations.
Even though palliative care is included in some nations’ public health policies, implementation in the community is often dependent on advocacy and financial support from non-governmental organizations. Palliative care strategies must be created in each country based on the demographics of the population. Rural or remote areas have an insufficient demand for specific palliative care beds due to their smaller population. Due to this, the palliative care team should develop appropriate intervention strategies involving the community. Furthermore, limited access to specialist health facilities, geographic remoteness, lack of transportation, and difficulties hiring and/or funding healthcare providers are all problems that might impact rural palliative care.
LMICs rely on partnerships with non-governmental organization to support palliative care, which could be unsustainable in the long term. To have a successful implementation, networking is essential to coordinate treatment and medicine availability near patient homes. Networked services to ensure medicines and care are accessible in the community, as well as training that includes community members, such as community volunteers and religious leaders, alongside healthcare professionals, are two key processes that may support palliative care in rural and remote areas.
Overall, a collaborative approach involving government, health services, professionals, and the community is required for the successful introduction and development of palliative care in rural areas of low and middle-income nations.
- Aregay A, O’Connor M, Stow J, Ayers N, Lee S. Strategies used to establish palliative care in rural low- and middle-income countries: An integrative review. Health Policy and Planning. 2020 Oct;35(8):1110–29. Available from: https://pubmed.ncbi.nlm.nih.gov/32577766/
