Dr Dan Munday, Dr Ruth Powys, Professor Bishnu Paudel and Professor Rajesh Gongal, explain the background to their longer article published in the January/February issue of the European Journal of Palliative Care.
In October 2017, the World Hospice and Palliative Care Day, ‘Don’t Leave the Suffering Behind, focused on Universal Health Coverage (UHC). UHC, recognized as essential for achieving Sustainable Development Goal 3 – Good Health and Wellbeing for all by 2030 – has been defined by the World Health Organization as “all individuals and communities receiv[ing] the health services they need without suffering financial hardship. It includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.” 1
Our article in the current edition of the EJPC, ‘Palliative Care in Nepal: Current steps to achieving Universal Health Coverage’, explores the progress so far in making palliative care, as part of UHC, a reality in this beautiful Himalayan country.
Much of Nepal is sparsely populated with long distances travelled over difficult terrain for people to reach even basic health care. Yet in Nepal, as in other low-income countries, increasingly more people are suffering from non-communicable diseases. Chronic disease management, including palliative care, needs to be provided by the primary healthcare workers in these remote areas.
In 2017, Nepal adopted a National Strategy for Palliative Care that recognizes the need for providing appropriate palliative care in all parts of the country. It builds on the firm foundation that has been developing over the last 20 years and recognizes Nepal’s other health resources, including highly trained general practitioners who often work in rural hospitals. The strategy sets a framework for development over the next 10 years to ensure that those suffering, even in remote areas, are not left behind.
Each of the article’s authors, has been involved in different ways in developing palliative care in Nepal: establishing hospice and palliative care services, securing ‘in country’ morphine production, running training programmes, and undertaking needs assessment research. Along with colleagues in the Nepalese Association for Palliative Care (NAPCare) and international partners, including Two Worlds Cancer Collaboration and EMMS International, they have been centrally involved in developing the national strategy.
Work started in Nepal has also led to international collaboration with colleagues in other settings where access to health care is challenging. Together we have been developing the Supportive and Palliative Care Indicator Tool for low-income settings (SPICT-LIS) due to be launched later this year. 2
As we work to ensure palliative care is available even for the most marginalized, we hope that our experiences in Nepal will enable us all to catch the vision and potential of UHC.
References and Links
1. Universal health coverage (UHC) fact sheet (accessed 07.02.2018).
2. Supportive and Palliative Care Indicator Tool for low-income settings (SPICT-LIS) (accessed 07.02.2018).
- Nepalese Association for Palliative Care (NAPCare).
- Two Worlds Cancer Collaboration.
- EMMS International.
More about the authors …
Dan Munday and Ruth Powys are medical consultants from the UK and Australia, respectively, who have been based in Nepal and involved in palliative care development and needs assessment work in Nepal over the last five years. Dan is visiting professor at the National Academy of Medical Sciences (NAMS) and adviser to NAPCare. Ruth is based at Green Pastures Hospital in Pokhara.
Bishnu Paudel is Professor of Medical Oncology at NAMS, consultant at Thankot Hospice, Kathmandu and President of NAPCare.
Rajesh Gongal is Professor of Surgery and Rector of Patan Academy of Health Sciences. Along with colleagues, Rajesh founded Hospice Nepal in 2000.
Read the full article in the European Journal of Palliative Care
This post relates to ‘Palliative Care in Nepal: Current steps to achieving Universal Health Coverage’ by Dan Munday, Ruth Powys, Bishnu Paudel and Rajesh Gongal is published in the January/February 2018 edition of the European Journal of Palliative Care (EJPC) (vol. 25 (1).
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Read more posts relating to articles published in the European Journal of Palliative Care on the EAPC Blog.