INDIA’S PALLIATIVE CARE

INDIA’S PALLIATIVE CARE

WHAT IS PALLIATIVE CARE ?

• Palliative care is care meant to improve the quality of life of patients who have a serious or life-threatening disease, such as cancer.
• It can be given with or without curative care.
• Palliative care is an approach to care that addresses the person as a whole, not just their disease.
• Palliative care is the branch of medicine focusing on improving the quality of life and preventing suffering among those with life-limiting illnesses.
• It aims to identify patients at risk of over-medicalisation at the expense of quality of life and financial burden on the family.
• It is often misinterpreted as end-of-life care.
• However, palliative care aims to improve the quality of life by addressing the physical, psychological, spiritual, and social domains of the health of people suffering from life-limiting diseases.

• Life-limiting diseases are like heart failure, kidney failure, certain neurological diseases, cancer, etc.
• Palliative care also includes bereavement support for the caregivers in case of the death of the patient.

CURRENT STATUS OF PALLIATIVE CARE IN INDIA :

• Despite various government programmes with palliative care provision as one of their objectives, like the National Programme for the Health Care of Elderly, access to palliative care continues to be abysmal.
• Apart from limiting its attention to cancer, the guidelines have also skipped an opportunity to bring focus on children suffering from chronic diseases.
• Despite needs at the grassroot level and international calls for including palliative care along with curative treatment, the realities on the ground are a far cry from what is desirable.

NEED OF PALLIATIVE CARE :

• Palliative care in India has largely been available at tertiary healthcare facilities in urban areas.
• Due to skewed availability of services, it is accessible to only 1­2% of the estimated 7­10 million people who require it in the country.
• As many as 7 out of the 10 patients need palliative care.
• Although three-tier health system, multiple national health programmes and schemes, and the Ayushman Bharat Health Insurance Scheme are all positive steps taken towards universal health coverage.
• But, despite these efforts, 55 million people in India are pushed below the poverty line every year due to health-related expenditures.

• Over-medicalisation plays a significant role in this financial burden.

CURRENTLY RUNNING PALLIATIVE CARE PROGRAMMES IN INDIA :

• The National Programme for Prevention & Control of Non-Communicable Diseases (NP­NCD), includes chronic diseases whose treatment contributes the most to health­ related expenses.
• These diseases progress to a stage where, in an ideal scenario, palliative care should take over curative care.
• Launched in 2010 to counter the rising burden of non­communicable diseases in the country.
• The programme envisaged the provision of promotive, preventive, and curative care from primary to tertiary institutes.

• The revised operational guidelines of NP­NCD were expected to strengthen the programme.
• However, it has not succeeded in addressing certain gaps in palliative care in India.

ISSUES IN INDIA’S PALLIATIVE CARE PROGRAMME :

• As per the Global Atlas of Palliative Care in 2020, the need for palliative care was higher for non ­cancer illnesses.
• However, the revised NP­NCD operational guidelines, released in May 2023, mention palliative care in synonymy with just cancer.
• Palliative care service delivery starts only from the district hospital in the revised guidelines, with no mention of home­based care.
• Apart from limiting its attention to cancer, the guidelines have also skipped an opportunity to bring focus on children suffering from chronic diseases.
• Experiences from the field suggest that many medical officers at primary health centres are not aware of the existence of any such programme.

WAY FORWARD :

• It is high time we realised the ongoing pandemic of non­communicable diseases in India and strengthened our palliative care services.
• The linkages with programme could improve the provision of palliative care.
• The World Health Organization recommends the use of morphine consumption per capita to assess morphine access for palliative care services.

SOURCE : THE HINDU

SYLLABUS : MAINS, GS-3, HEALTH