Palliative Care in India: Need & Associated Challenges

Context (TH): In India, millions endure unnecessary suffering, making it imperative to integrate palliative care into its healthcare system.

What is Palliative Care?

Palliative care is a form of specialised care that addresses a person’s physical, emotional, social, and spiritual needs.
Unlike curative treatment, which aims to eradicate disease, palliative care focuses on alleviating pain, reducing suffering, and improving the quality of life for patients and their families.
The demand for palliative care is increasing constantly due to the global rise in non-communicable diseases such as cancer, diabetes and chronic respiratory conditions.
According to WHO, an estimated 40 million people globally require palliative care each year, with 78% of them living in low & middle-income countries. However, only 14% of those in need receive such care.

Huge Demand, Minimal Access: Where an estimated 7-10 million people require palliative care annually, only 1-2% have access to it.
Strained Healthcare System: India’s healthcare system, which is already strained, faces increasing pressure, making it essential to integrate palliative care to reduce unnecessary hospitalisations.
Emotional and Financial Relief for Families: Palliative care eases patient suffering and lessens emotional and financial strain on families by avoiding costly, futile treatments.
Implementation Gaps: Though the National Health Policy (2017) recognises palliative care as essential, implementation remains weak due to limited funding, policy focus, and trained professionals.

Accessibility: Access remains uneven, particularly in rural and economically disadvantaged areas. Systemic inefficiencies continue to impede its effective delivery.
Shortage of Trained Professionals: While India’s doctor-population ratio of 1:834 exceeds the WHO norm of 1:1000, the shortage of specialists in palliative care limits access to comprehensive pain management and end-of-life support.
Limited Funding and Infrastructure: Inadequate financial support and poor infrastructure hinder the expansion and delivery of quality palliative care services.
Incomplete Integration: Although palliative care is part of the primary healthcare framework, its integration into tertiary care settings remains insufficient.
Cultural and Social Barriers: In many parts of India, discussions around death, terminal illness, and palliative care are taboo, making families reluctant to seek such services early.

Community and Tele-Palliative Care: Leverage telemedicine and community-based models by training frontline workers like ASHAs to deliver basic palliative support and facilitate remote consultations in rural and underserved regions.
Medical Education: Integrate palliative care into the MBBS curriculum to build doctors’ capacity, especially in underserved areas.
Task-Shifting: Train nurses and allied health professionals to deliver palliative care, leveraging India’s large healthcare workforce.
Insurance Coverage: Expand schemes like Ayushman Bharat to include palliative care, improving financial accessibility.
Research & Policy: Promote evidence-based practices and continuous research to guide effective policy and implementation.