As we join the rest of the world to commemorate Universal Health Coverage Day this December, it is important for the proponents and advocates of palliative care to be proactive in making the case for palliative care inclusion into UHC and eliciting the political will and action to do so.
There is no doubt about the role that palliative care plays in alleviating physical, social, psychological and spiritual suffering and improving the quality of life for people with life-limiting illnesses, whether they are communicable or non communicable conditions, and whether those affected are children or adults. It is cost effective where it is available, it helps people not to be hospitalised unnecessarily, but instead receive care in a place of their choice.
PC in UHC
While palliative care is recognised by the World Health Organization (WHO) as a core component of Universal Health Coverage (UHC), access to this essential health service has remained limited in Africa due its low integration in mainstream health systems. So, at this time when many nations are working to develop strategies and plans on how to achieve Universal Health Coverage, this UHC Day presents yet another opportunity for advocates and supporters of palliative care to ensure that PC is fully integrated in the minimum package that is requisite for the attainment of UHC in their countries.
A tool for palliative care advocacy
This article presents a tool that such advocates can use in demanding prioritisation of palliative care at national level; the ESSENTIAL PALLIATIVE CARE PACKAGE FOR UNIVERSAL HEALTH COVERAGE. The package is presented as a compact, brief and concise tool with a clear message targeting health gatekeepers and other providers of primary health care services. Developed by palliative care patients, activists and technical experts, with funding from the Open Society Foundations and Open Society Initiative for Eastern Africa, it is a tool that programme planners and national UHC policy makers and implementers can use to quantify and cost palliative care within UHC. It is practical and can be adapted to specific local needs.
The package gives a detailed evidence-based rationale for the inclusion of palliative care as essential for UHC. It then gives the 4 essential components as;
- Essential palliative care medicines: As recommended by the 2017 WHO’s Essential Medicines Lists for Adults and Children.
- Essential Equipment, patient supportive devices, technologies and supplies: Would include items like pressure-reducing mattresses, appropriate prostheses, opioid lock boxes, colostomy bags, adult diapers, etc.
- Human Resources: Skilled health workers for palliative care as defined by the WHO and APCA Palliative Care Standards, which recognise the need for multi-disciplinary teams. Also includes official recognition of palliative care specialists with appropriate deployment and remuneration.
- Psychosocial interventions: A range of psychosocial interventions, including spiritual care, legal aid and social support such as subsidies for the most vulnerable, e.g. through collaboration with other ministries such as Social Development/Social Security and Civil Society Organizations.
For the detailed Essential Palliative Care Package for Universal Health Coverage click here.
For further support
Further technical support for the adoption or adaptation of this package to the needs of countries is accessible from the African Palliative Care Association (APCA), the Worldwide Hospice Palliative Care Alliance (WHPCA), and national palliative care associations based on resource availability.