Expanding the Reach: Community-Based Palliative Care in Bangladesh

Categories: Community Engagement, Featured, Opinion, and Policy.

Worldwide Hospice and Palliative Care Day (WHPCD) is an annual unified day of action to celebrate and support hospice and palliative care around the world. It was established in 2005 and has become one of palliative care’s most significant global days.

Each year a different theme is chosen to emphasise an important aspect of palliative care. The theme for WHPCD 2023 is Compassionate Communities: Together for Palliative Care.

This theme highlights the importance of communities working together to ensure that everyone has access to the palliative care they need, when and where they need it. Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illnesses. It provides relief from pain and other distressing symptoms and offers support on physical, psychological, and spiritual levels. Palliative care can be provided at any stage of illness and can be continued into the end of life.

Palliative care is a specialised form of medical care that focuses on providing relief from the symptoms and suffering associated with serious illnesses, particularly those that are life-threatening or life-limiting. The goal of palliative care is to improve the quality of life for patients and their families facing these challenging situations.

Promoting palliative care in Bangladesh is crucial for addressing the healthcare needs of a growing population with chronic and life-limiting illnesses. It can improve the quality of life for patients, reduce suffering, and offer a compassionate approach to healthcare in a culturally sensitive manner.

Promoting palliative care is an important issue for Bangladesh for several reasons, given the country’s healthcare landscape and demographic challenges:

Aging Population: Bangladesh, like many countries, is experiencing an increase in its aging population. With aging comes a higher prevalence of chronic and life-limiting illnesses such as cancer, heart disease, and neurodegenerative disorders. Palliative care is crucial in addressing the complex needs of these elderly individuals and improving their quality of life.

High Disease Burden: Bangladesh faces a significant burden of non-communicable diseases (NCDs) such as cancer, diabetes, and cardiovascular diseases. Many of these diseases are associated with symptoms that can be effectively managed with palliative care, including pain, fatigue, and psychological distress.

Limited Access to Healthcare: Access to advanced medical treatments and specialized care can be challenging in some parts of Bangladesh, especially in rural areas. Palliative care can provide a cost-effective and compassionate approach to managing symptoms and improving the comfort of patients in underserved regions.

Cultural and Religious Factors: Bangladesh has a diverse population with varying cultural and religious beliefs. Palliative care can be tailored to respect these cultural and spiritual values, ensuring that patients and their families receive care that aligns with their beliefs and preferences.

Enhanced Quality of Life: Palliative care focuses on improving the quality of life for patients living with serious illnesses. This can have a significant impact on patients’ well-being, allowing them to better cope with their conditions and maintain their dignity.

Family Support: In Bangladesh, family plays a central role in healthcare decision-making and caregiving. Palliative care can provide much-needed support and education to families, helping them better care for their loved ones and reducing caregiver burden.

Humanitarian and Ethical Considerations: Palliative care is aligned with principles of compassion and human dignity. Ensuring access to palliative care is not only a matter of good medical practice but also a humanitarian and ethical imperative.

Economic Considerations: Palliative care can help reduce healthcare costs associated with unnecessary hospitalisations and aggressive treatments that may not align with patients’ wishes. By providing appropriate care in the community setting, it can contribute to more efficient healthcare spending.

Promoting access to palliative care services at the community level in Bangladesh

Despite the many benefits of palliative care, it remains underutilised in many parts of the world, including Bangladesh.

According to the World Health Organization (WHO), only 14% of people who need palliative care worldwide receive it. In Bangladesh, this number is even lower, with only an estimated 5% of people with advanced illnesses receiving palliative care.

There are a number of factors that contribute to the limited access to palliative care in Bangladesh. One factor is the lack of awareness of palliative care among both the public and healthcare professionals. Another factor is the stigma associated with palliative care, which is often seen as a sign that a person is dying. Additionally, there is a shortage of trained palliative care specialists in Bangladesh.

Despite these challenges, there are a number of things that can be done to promote access to palliative care services at the community level in Bangladesh.

One important step is to raise awareness of palliative care among the public and healthcare professionals. This can be done through public education campaigns, training programs for healthcare workers, and advocacy efforts. Another important step is to develop and strengthen community-based palliative care programs. These programs can provide palliative care services closer to where people live, making it more accessible and affordable. Community-based palliative care programs can also help to reduce the stigma associated with palliative care by increasing understanding of its benefits.

The following are some specific examples of how to promote access to palliative care services at the community level in Bangladesh:

Train community health workers in palliative care: Community health workers are often the first point of contact for people with healthcare needs. By training community health workers in palliative care, they can be equipped to identify and assess the needs of people with advanced illnesses, and to provide basic palliative care services.

Establish community-based palliative care teams: Community-based palliative care teams can provide a range of services to people with advanced illnesses and their families, including pain and symptom management, emotional support, and practical assistance. These teams can be made up of a variety of professionals, including doctors, nurses, social workers, and spiritual care providers.

Integrate palliative care into existing healthcare services: Palliative care can be integrated into existing healthcare services, such as hospitals, clinics, and nursing homes. This makes it easier for people to access palliative care services without having to go to a specialised palliative care centre.

Develop and implement palliative care policies and guidelines: The government of Bangladesh can play an important role in promoting access to palliative care by developing and implementing palliative care policies and guidelines. These policies and guidelines can help to ensure that palliative care is integrated into the healthcare system and that it is accessible to all who need it.

It’s highly notable that, a development initiative is being implemented with the support of the Non-Communicable Disease Control (NCDC) programme of the Directorate General of Health Services (DGHS) at Narayanganj District namely “Compassionate Narayanganj” and the project title is `Building an Integrated age-attuned model of supportive palliative care in Bangladesh’ as a piloting initiative of AYAT Education in collaboration with WHPCA, BSMMU, St. Christopher’s home, and Narayanganj City Corporation. This project aims to integrate palliative care into the public health system by upskilling the youth volunteers, health workers, nurses, and physicians working at the subdistrict level and in rural communities.

World Hospice and Palliative Care Day 2023 is an opportunity to raise awareness of the importance of palliative care and to advocate for greater access to palliative care services for everyone who needs it. By promoting access to palliative care services at the community level in Bangladesh, we can help to ensure that everyone has the opportunity to live a life with dignity and comfort, even in the face of serious illness and death.

You can reach the author via E-mail: sumitbd.writer@gmail.com

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