Integrated management of non-communicable diseases in low-income settings: palliative care, primary care and community health synergies.
India
Nepal
community health
low and middle income countries
non-communicable disease management
palliative care
primary care
universal health coverage
Journal
BMJ supportive & palliative care
ISSN: 2045-4368
Titre abrégé: BMJ Support Palliat Care
Pays: England
ID NLM: 101565123
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
24
05
2018
revised:
30
08
2018
accepted:
12
09
2018
pubmed:
6
11
2018
medline:
4
3
2020
entrez:
4
11
2018
Statut:
ppublish
Résumé
Palliative care is recognised as a fundamental component of Universal Health Coverage (UHC), which individual countries, led by the United Nations and the WHO, are committed to achieving worldwide by 2030-Sustainable Development Goal (SDG) 3.8. As the incidence of non-communicable diseases (NCD) in low-income and middle-income countries (LMICs) increases, their prevention and control are the central aspects of UHC in these areas. While the main focus is on reducing premature mortality from NCDs (SDG 3.4), palliative care is becoming increasingly important in LMICs, in which 80% of the need is found. This paper discusses the challenges of providing comprehensive NCD management in LMICs, the role of palliative care in addressing the huge and growing burden of serious health-related suffering, and also its scope for leveraging various aspects of primary care NCD management. Drawing on experiences in India and Nepal, and particularly a project on the India-Nepal border in which palliative care, community health and primary care-led NCD management are being integrated, we explore the synergies arising and describe a model where palliative care is integral to the whole spectrum of NCD management, from promotion and prevention, through treatment, rehabilitation and palliation. We believe this model could provide a framework for integrated NCD management more generally in rural India and Nepal and also other LMICs as they work to make NCD management as part of UHC a reality.
Identifiants
pubmed: 30389694
pii: bmjspcare-2018-001579
doi: 10.1136/bmjspcare-2018-001579
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e32Informations de copyright
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: VK and SK are employed by Duncan Hospital. DM undertook an evaluation of the CHETNA programme at Duncan Hospital, for which he received expenses but was not paid, and he evaluated the original EHA palliative care programme, for which he received an honorarium. LG has no conflict of interest to declare.