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.

Need for Palliative Care in India

• 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.

Associated Challenges

• 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.

Way Forward

• 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.