Calculating the global need for children’s palliative care

Categories: Research.

As the first presenter at the recent side event on children’s palliative care during the 68th World Health Assembly (WHA) ICPCN’s chief executive, Joan Marston, spoke on the global need for children’s palliative care and provided some interesting statistics.

Saying that nothing we do is of importance unless it impacts on children and families, Joan spoke about separating the need for children from that of adults citing the far wider range of conditions to consider in children’s palliative care as well as a broad age range – from neonates right through to young adults.

Childhood mortality statistics reveal that 9 million children died last year with 6.3 million of them being under 5. Of this who died, 44% were neonates, which is why neonatal palliative care is a vital and growing component of providing children’s palliative care.

The need for children’s palliative care
The presentation looked at research undertaken by UNICEF and ICPCN developing a methodology to identify the need for children’s palliative care, what was present in the country and the provision gaps. Using this methodology, the researchers have now looked at 59.6% of the world’s children and extrapolated the results to produce the following figures:

  • Around 21 million children worldwide would benefit from palliative care
  • Around 8 million children within that 21 million need more specialised palliative care provision
  • The average prevalence is 44 in 10 000 children with very large variations ranging from, for example, 21 in 10 000 in Australia to 119 in 10 000 in Zimbabwe
  • HIV has had a significant impact on these figures
  • India has the highest need. Over 6 million children in this country would benefit from palliative care, with 1.6 needing specialised care.
  • Globally less than 1% of children are having their palliative care needs met
  • The biggest gaps in provision can be found in Africa, parts of Latin America, Asia and the Pacific Islands.

Listing some of the barriers that exist to the provision of services for children Joan spoke of a lack of resources in lower income countries, the fear of using opioids for children’s pain as well as minimal opportunities to receive appropriate education. A suggested solution would be to introduce children’s palliative care into all undergraduate studies for doctors, nurses, social workers, chaplains and other members of the multidisciplinary team.

Joan also spoke of the work of the ICPCN to overcome the lack of education through their E-learning modules, presently available in 8 languages with modules in Hindi and Czech in development.

Finally she encouraged those present by saying that although large, 21 million children is still a ‘reachable’ number and if we work to provide education and integration of services into health systems, it is not impossible to meet the need.

Click here to find more information on the side event and download the presentation.