Policy to Practice: Founding the National Children’s Hospital Paediatric Palliative Care Centre

By Adelina Uyvico, M.D., Rhea Angelica Jayma, M.D. and Maria Liza Naranjo, M.D.

The National Children’s Hospital (NCH) Paediatric Palliative Care (PPC) Centre in Quezon City, Philippines, stands as a testament to how national policy, visionary leadership, and global collaboration can translate compassion into sustainable care for children with life-limiting illnesses.

In 2019, two landmark laws—the National Integrated Cancer Control Act and the Universal Health Care Act —recognized palliative care as an essential component of health services. These policies provided the foundation for NCH to formalize paediatric palliative care within its systems. Under the leadership of Medical Director Dr. Epifania Simbul, and advocates Dr. Yasmin Sulit and Dr. Maria Liza Naranjo, the hospital convened its first interprofessional stakeholders’ meeting together with Dr Agnes Bausa, becoming the impetus that would lead to the formation of the NCH PPC Team. Thereafter, Dr. Rhea P. Jayma was appointed the inaugural Chair of the Paediatric Palliative Care Centre, ensuring that the emerging service was grounded in family-centred principles.

Capacity Building and Global Collaboration

The centre’s evolution was propelled by a strong capacity-building trajectory that began with the training of three paediatricians at the WHO Collaborating Centre for Community Participation in Palliative Care and Long-Term Care at the Institute of Palliative Medicine in Kerala, India. This experience inspired Dr. Xiohara Gentica to pursue a transformative partnership between NCH and the Two Worlds Cancer Collaboration (TWCC), linking the Philippines with a global network of paediatric palliative care educators.

Under the mentorship of Dr. Megan Doherty and Dr. Gayatri Palat, TWCC provided structured one-year fellowship training for NCH pediatricians Dr. Gentica, Dr. Lannie Fofue, Dr. Adelina Uyvico, and Dr. Leicel Goyena. The program included rotations at the MNJ Institute of Oncology and Regional Cancer Centre and the Kumudini and Mandara Hospices in Hyderabad, complemented by academic sessions with TWCC faculty Dr. Stuart Brown, Dr. Spandana Rayala, Dr. Ross Pinkerton, and Prof. Camara van Breemen.

What made this model unique was its dual mentorship approach: while TWCC faculty delivered structured global training, Dr. Rhea Jayma guided local bedside mentorship, contextualizing lessons within Philippine culture and health-system realities. This synthesis of global standards and local wisdom produced the country’s first formally trained cohort of paediatric palliative care specialists—creating a ripple effect of education, advocacy, and clinical excellence.

(Pictured: The early days: A Stakeholder’s meeting)

Integration and Sustainability

Parallel to training, NCH institutionalized PPC by developing a Manual of Operations aligned with Department of Health (DOH) standards. In 2024, the DOH designated NCH as a pilot site for the national roll-out of the Manual of Operations, Procedures, and Standards for Palliative and Hospice Care. The hospital also became the Philippine iECHO Hub for Paediatric Palliative Care, extending mentorship and education nationwide. Sustainability is anchored on interprofessional staffing—dedicated PPC nurses and social workers ensure continuity of care across hospital and home.

Key Lessons Learned

The NCH experience shows that investing in people, creating spaces for mentorship, and embedding palliative care within policy frameworks transform advocacy into action. From Kerala to Hyderabad and back home to Quezon City, the NCH PPC story illustrates how compassion, collaboration, and courage can build a national model of hope and healing for every Filipino child.