Palliative Care: The Public Health Strategy
- 110 Downloads
- 30 Citations
Abstract
There is the knowledge to improve the Quality of Life, Dying and Death of cancer sufferers, other patients dying of chronic diseases, HIV/AIDS and the children and elderly terminally ill and their caring family members, an estimated 100 million people globally, if palliative care and pain relief would be available. Tragically however, palliative care is only reaching a lucky few. Two third of those in need of palliative care are in the low or middle income countries.
The World Health Organization (WHO) has pioneered a public health strategy to integrate palliative care into existing healthcare systems as this offers the best approach for translating new knowledge and skills into evidence-based, cost-effective interventions that can reach everyone in the population, when incorporated by governments into all levels of their healthcare systems and owned by the community. The WHO Strategy starts by establishing four foundation measures, key components that are: 1) appropriate policies, 2) adequate drug availability, 3) education of the public, policymakers and the public and 4) implementation.
The WHO Model has shown that it provides an effective strategy for countries to establish palliative care. The Open Society Institute has actively supported countries to establish National Palliative Care Programs according to these principles. Combined with a community strategy that involves the society through collective and social action“Palliative Care for All” indeed could become a reality.
Keywords
palliative care Public Health World Health OrganizationReferences
- Stjernsward J, Clark D . Palliative Medicine-a Global Perspective. In: Doyle D, Hanks G et al., editors. Oxford Textbook of Palliative Medicine, 3rd edition, Chapter: 21 1196–1224. Oxford: Oxford University Press; 2004.Google Scholar
- Stjernsward J, Colleau S, Ventafridda V . The World Health Organization Cancer pain relief and palliative care program: past, present and future. J Pain Symptom Manage. 1996;12 (2):65–72.CrossRefGoogle Scholar
- WHO. Cancer Pain Relief, First edition, Geneva: WHO; 1986, and WHO. Cancer Pain Relief. With a guide to opioid availability, 2nd edition. Geneva: WHO; 1996.Google Scholar
- WHO. Cancer Pain Relief and Palliative Care. WHO Technical Report Series 804, 1990;1–74 (Pages 65–66).Google Scholar
- WHO. National Cancer Control Programmes: Polices and Managerial Guidelines. WHO, CAN 92.1, 1992 (Limited edition) and WHO, Geneva 1995 (1st edition) and WHO 2002 (2nd edition) 1992–2002.Google Scholar
- Jerry LJ, Stjernswärd J, (editors). Advances in National Cancer Control: Managerial Aspects. Calgary, Canada: World Health Organization Collaborating Centre for Cancer Control; 1996.Google Scholar
- NSW Cancer Council. Proceedings of the Third International Working Group on National Cancer Control Programs. Sydney, Australia: NSW Cancer Council; 1996.Google Scholar
- Bruera E, Schoeller MT, Stjernsward J . Opioid availability in Latin America: the declaration of Florinapolis. Support Care Cancer. 1995;3 (3):164–167.CrossRefGoogle Scholar
- The Poznan Declaration 1998. European J Palliative Care. 1999;6:61–63.Google Scholar
- Cancer Control Workshop, South Africa. Workshop Proceedings Report, Cancer Association of South Africa, Johannesburg 1994.Google Scholar
- Open Society Institute, OSI, International Palliative Care Initiative:1) “Palliative Care Development Seminar”, Budapest, October, 2000, 2) “Palliative Care Policy Development Conference”, Budapest, October 2003, and 3) “Palliative Care in Cancer” Budapest, September 2005, Open society Institute, New York 2000, 2003, 2005.Google Scholar
- WHO. Bridging the Know-Do-Gap in global health. Special issue, Bulletin WHO. 2004;82 (10).Google Scholar
- Gómez Batiste X, Borrás JM, Fontanals MD, Stjernsward J, Trias X . Palliative care in Catalonia 1990–95. Palliative Med. 1995;6:321–327.CrossRefGoogle Scholar
- Gomez-Batiste X, Porta J, Tuca A, Corrales E, Madrid F, Trelis J . The WHO Demonstration Project of Palliative Care Implementation in Catalonia. Results at 10 years (1991–2001). J Pain Symptom Manage. 2002;24 (2):239–244.CrossRefGoogle Scholar
- Gómez-Batiste X, Porta-Sales J, Pascual A, Nabal M, Espinosa J, Paz S . Catalonia WHO demonstration project on palliative care implementation: quantitative, qualitative results and proposal for improvements at 15 years (2005). J Pain Symptom Manage. 2007; in press.Google Scholar
- Stjernsward J . Uganda: establishing a government public health approach to pain relief and palliative care. J Pain Symptom Manage. 2002;24 (2):257–264.CrossRefGoogle Scholar
- Daher M, Tabari H, Stjernsward J, Ammar W, Nabhan TA, Khalil MB . Lebanon: introducing pain relief and palliative care. J Pain Symptom Manage.. 2002;24 (2):200–205.CrossRefGoogle Scholar
- Mongolia (2002–2006); Stjernsward J, Odontuya Davaasuren, (2004) Report; “Mongolia National Palliative Care Programme”, Ulaanbaatar 2004, d_odontuya@yahoo.com, janstjernsward@hotmail.com, and Good Prescription Practise, Minister of Health Resolution MNS 5376:2004, and Development of palliative care 2006–2009, Ministry of Health, Resolution 246:2005 and National Standards, MNS 5455-2:2005.Google Scholar
- Stjernswärd J . Georgia-National Palliative Care Program. Tbilisi, Georgia: Georgian Parliament; 2006. Available at http://www.parliament.ge/files/619_8111_336972_Paliativi-Eng.pdf.Google Scholar
- Stjernsward J . Community participation in palliative care. Indian J Palliat Care. 2005;11 (2):52–58.CrossRefGoogle Scholar
- Kerala, NNPC. Work Book: International Workshop on Community Participation in Palliative Care. Manjeri, Malappuram District, Kerala November 26–28, 2004 by NNPC groups, Department of Community Medicine and Institute of Palliative Medicine, Medical College, Calicut, Kerala, 673008 India 2004.Google Scholar
- Kumar S, Numpeli M . Neighborhood network in palliative care. Indian J Palliat Care. 2005;11:6–9.CrossRefGoogle Scholar
- Kumar S . The chronically and incurably ill: barriers to care. In: The Commonwealth Ministers Reference Book. Bradford, United Kingdom: The University of Bradford Press; 2006. p. 2–5.Google Scholar