The WHO launches a set of indicators to evaluate and monitor the development of palliative care worldwide

The World Health Organization (WHO) has published the consensus of a set of indicators to evaluate and monitor the development of palliative care worldwide. The report was presented last week at the 17th Palliative Care World Congress in a joint symposium of the WHO and the European Association for Palliative Care.

Who was behind the report?

In the report, they have participated over 50 experts from over 20 countries under the scientific coordination of the ATLANTES Global Palliative Care Observatory of the University of Navarra, and including officers from the WHO different regional headquarters. The work was completed under the supervision of Marie-Charlotte Bouësseau and Anna Ray, from the WHO Integrated Health Services Department.

Participating experts: Samy Alsirafy, Natalia Arias-Casais, Carlos Centeno, Stephen Connor, Julia Downing, Cynthia Goh, Liz Grant, Ednin Hamzah, Richard Harding, Aleksandra Kotlinska-Lemieszek, Eric Krakauer, Liliana de Lima, Emmanuel Luyirika, José María Martín Moreno, Alberto Meléndez, Eve Namisango, Hibah Osman, Pedro Emilio Pérez Cruz, Lukas Radbruch, MR Rajagopal, Smriti Rana, Anna Ray, Miguel Sánchez-Cárdenas , Xavier Gómez-Batiste, Viktoriia Tymoshevska, Yahyo Ziyaev. Contributors from WHO were Aditi Bana, Shannon Barkley, Marilys Corbex, Jean Marie Dangou, Neelam Dhingra-Kumar, Elena Fidarova, Edward Kelley, Silvana Luciani, Kathryn O´neill, Nasim Pourghazian, Zhang Qi, Briana Rivas, Sohel Saikat, Slim Slama, Yuka Sumi, Shams Syed, and Cherian Varghese

What does it pursue?

The work aimed at identifying a refined set of indicators to monitor the development of palliative care programmes in different contexts, especially in countries where palliative care is at an initial stage of development. It was conducted with the aim of offering governors, policymakers, and social agents a tool to detect areas for improvement in the national development of palliative care. 

What were the main findings?   

A working concept of palliative care development was agreed by the group that fed into an updated palliative care development conceptual model. The new conceptual framework has been illustrated through a palliative care house, built with six elements. In the basement, the capacity of society and individuals of promoting palliative care and the government´s ability to promote palliative care through adequate health policies. The floor of the building is research, that generates the scientific evidence for performing an advanced medicine.

The walls represent “well trained and educated professionals, and the availability of essential medicines to relieve pain”. And above these walls, the roof representing the development of integrated palliative care services within national health systems to match patients and families´ needs.  The architecture of the house should reflect the specific context in each country. Each country must build this house with available materials and in its own style its health system, considering its social and cultural specificities, and its available resources.

Applying the updated palliative care development conceptual model, two distinct menus of indicators were developed: 1st) 10 core indicators that are considered to be essential indicators for the measurement of palliative care both in-country and for global comparative

analysis were identified, and 2nd) 9 strategic indicators most feasible and important to measure in countries where palliative care is only in the initial stages of development.

What is next?

The WHO and the experts aspire the report to be used by countries to guide the selection of palliative care indicators and integrate them within the monitoring frameworks of national strategies, policies and plans. The indicators should be selected and adjusted according to the country context, considering elements such as the stage of palliative care development, input from stakeholders and alignment with existing health information systems. 

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