Palliative Care is in the very definition of Universal Health Coverage, so why wait?
Universal Health Coverage day was observed across the world on 12 Dec 2018. To commemorate this day, Government Medical College, Thiruvananthapuram and Pallium India Trust organized a workshop on 11th December, titled “Palliative Care & Universal Health Coverage in Kerala – The Way Forward, Call for Action Based on Astana Declaration”.
The workshop was led by eminent personalities like Shri Rajeev Sadanandan IAS (Additional Chief Secretary, MoH&FW, Kerala), Shri Kesav Desiraju IAS (Former Principal Secretary, MoH&FW, GoI), Shri SM Vijayanand IAS (Former Chief Secretary, Kerala), Dr TK Sundari Ravindran (Former Professor, AMCHSS, SCTIMST), Shri Narayanan Puthukudy (General Secretary, IAPC-Kerala), Dr Thomas Mathew (Principal, Govt. Medical College, Thiruvananthapuram) and Dr M.R Rajagopal (Chairman, Pallium India). Although it was a hartal day in Thiruvananthapuram district, more than 150 participants managed to join the workshop which calls out loudly the importance given to palliative care by our civil society.
The discussion began with emphasizing the need to include palliative care in primary health care and then moved on to a wide array of components. A few important points were the life cycle approach of Ardram mission, requirement of human resource and capacity building in palliative care delivery, absence of palliative care package in the new public health insurance scheme, absence of palliative care training in medical, nursing and allied health sciences, a monitoring agency to look into the implementation, synergizing with various departments for effective implementation, importance of initiating and delivering paediatric palliative care services, implementation of Clinical Establishment Act, gender disparity in accessing, care givers’ plight and disability that also includes disability arising due to mental health issues.
Developing a pool of volunteers at state level and student volunteers was also suggested as community engagement in National Health Policy 2017 was reinforced through Astana Declaration. Although Indian Constitution regards improvement of public health as state’s primary duty, we spend less that 1% of our GDP for public health expenditure. According to Lancet Commission Report, minimum cost per capita for palliative care service delivery ranges from $ 115 to $ 694.
The program concluded with a declaration to take palliative care forward in Kerala. This declaration will be submitted to government of Kerala, GoI and to all other state governments to strengthen palliative care services.
Would it be possible for us to deliver quality palliative care to all in the near future? If not, how does India achieve UHC by 2030? Let us wait for something good to happen but until then let us not sit idle.