The World Health Organization (WHO) estimates that worldwide, only about 14% of people who need palliative care currently receive it. Further, WHO suggests that adequate national policies, programs, resources, and training on palliative care among health professionals are urgently needed to improve access.
In 2021, the WHO released a model to guide countries in the development of palliative care. The model is a result of consensus among palliative care experts and builds on previous models and frameworks. The model includes 18 indicators that align with six dimensions of palliative care development (health policies related to palliative care, use of essential medicines, provision of palliative care in integrated health service delivery platforms, education and training, research and empowered people and communities).
Sanchez-Cardenas and colleagues (2022) conducted a study to analyze national palliative care plans using the WHO palliative care development assessment model. The authors conducted a documentary and framework analysis of national palliative care plans to compare their content with the WHO’s model of palliative care development. They examined three phases including: development of the plan, components of the plan and implementation of national plans.
The authors identified 112 countries where a national palliative care plan might exist. After applying the inclusion and exclusion criteria, 31 countries remained for the analysis.
Development of the plan: Only two national plans were written prior to 2007, 10 plans were published between 2007 and 2013 and the remaining 19 were published after 2014.
Components of the plan: Eight countries mentioned all six WHO dimensions of palliative care development, and none of these are high-income countries. The dimensions were identified in the following proportions: integrated health services (100%), education and training (93%), research (83%), empowered people and communities (80%), health policies (54%), and use of essential medicines (48%). Of note, the authors only identified four of the six dimensions in the Action Plan on Palliative Care: Building on the Framework on Palliative Care in Canada.
Implementation of national plans: The majority of plans mentioned an implementation strategy (93%), and 74% include a method of monitoring plan implementation. A mention of plan funding is included in 77% of plans while less than half (48%) allocate economic resources for their implementation.
While the importance of having a national palliative care plan has been acknowledged, few countries have entirely adopted the WHO model and fewer have allocated resources for implementation.
Source: Cárdenas, M. A. S., Morales, J. E. C., & Sánchez, J. C. (2022). Inclusion of essential components of the World Health Organization Palliative Care Development Model in national palliative care plans: A documentary analysis in 31 countries. Health Policy.
