Authors: Dr Fyeza Hasan, Dr Huma Zafar, Dr Resham Shahzadi,
Pakistan is the world’s fifth most populous country. The healthcare infrastructure is fragile, and resources are limited for the treatment of complex medical conditions. Both culturally and socially applicable palliative care principles are not part of routine medical care, and emphasis is on treating patients with curable medical conditions. Around 7,500–8,000 children develop cancer annually, yet only half receive treatment, and even fewer survive. Children with other life-limiting illnesses present with complex symptoms. Pediatric palliative care (PPC) remains underdeveloped, hindered by limited resources and trained personnel. Most children present late with complex needs, leaving families overwhelmed and unsupported. Recognizing the need to build capacity, the 1st Pakistan Pediatric Palliative Care ECHO Series was launched as a nationwide, groundbreaking virtual learning initiative to expand access to training, mentorship, and peer learning for healthcare professionals (HCPs).
It all started in 2024, when Dr. Huma Zafar from University of Child Health Sciences Lahore, Pakistan participated in a one-year Pediatric Palliative Care Fellowship offered by The Sunflower Children’s Network, an initiative by TWCC. This program trains the physicians to become specialists and leaders in pediatric palliative care. The fellowship includes formal teaching, clinical rotations, mentorship, and a scholarly project as well as the ECHO series. The program is endorsed by the Royal College of Pediatrics and Child Health (UK).
The pediatric palliative care fellowship in Pakistan significantly elevated the standard of care by training the fellow in managing complex, life-limiting conditions in children. It promoted holistic, family-centered care, which reduced suffering and enhanced quality of life. The fellow can further play a key role in standardizing protocols, educating healthcare providers, and advocating for integration into national health policies. Through research and leadership, a sustainable model for compassionate, evidence-based pediatric care can be established.
Following this successful fellowship, it was established that the six-week ECHO series is a great tool to explore foundational principles of pediatric palliative care, covering a range of essential topics such as the concept of PPC, pain and symptom management, communication, end-of-life care and grief support. Proudly endorsed by the Royal College of Paediatrics and Child Health (RCPCH), the series is based on the ECHO model (Extension for Community Healthcare Outcomes), which uses technology to bridge knowledge gaps and build learning communities.
The program brings together a growing network of international collaborators including the International Children’s Palliative Care Network (ICPCN), St. Jude Children’s Research Hospital, Stanford’s Quality of Life for All (QoLA) initiative, and Two Worlds Cancer Collaboration. These partnerships reflect a shared commitment to the belief that every child, regardless of where they are born, deserves dignity, comfort, and holistic care. The goal of these collaborations is to promote best practices and support the development of locally adaptable, evidence-based approaches to PPC delivery across Pakistan.
The ECHO series is open to all healthcare professionals involved in the care of children with both oncological and non-oncological life-limiting conditions. Participants include physicians, nurses, psychologists, social workers, and allied health staff from across the country. Each session features expert-led presentations both from national and international experts, case-based learning, and interactive discussions that encourage reflective practice. A strong focus on contextually relevant case sharing has provided deep insight into the specific challenges and opportunities within Pakistan’s healthcare landscape.
As we move forward, our vision for pediatric palliative care in Pakistan is to make it a standard part of healthcare. These educational activities will play a vital role in raising awareness and deepening the understanding of PPC principles among healthcare providers, including physicians, nurses, and allied staff. These efforts will focus on embedding PPC into clinical practice, ensuring holistic and compassionate care for children with life-limiting illnesses. This series is the foundation for a national network of trained professionals, a collaborative knowledge hub, and a unified community of practice dedicated to integrating PPC within mainstream pediatric care.
Leave a Reply