TRANSLATIONAL AND CLINICAL MEDICINE - Georgian Medical Journal

Introduction

35% of the global population is under 20 years of age. There are an estimated 21.6 million children globally who need access to children’s palliative care (CPC), with at least 8 million of those needing specialist care. Yet it is estimated that only between 5-10% of those children needing palliative care can access it, with 97% of these living in low- and middle-income settings. Thus, children around the world are experiencing needless suffering, as we know how to provide palliative care for children, to manage their pain, to manage their symptoms, to provide physical, psychological, social and spiritual care within an appropriate cultural context.

Aim

The aim of this presentation is to explore the global need and provision of CPC, highlighting the global health perspective, models of CPC provision, the benefits of CPC, the barriers to the provision of CPC and some overarching standards for CPC provision.

Methods

The literature will be reviewed with regards to the need for CPC, in particular looking at research to understand the global need for CPC, including the global atlas for end-of-life care, ICPCN’s estimation of need and the Lancet Commission report on Alleviating the access abyss in palliative care and pain relief – an imperative of universal health coverage. Examples of research undertaken to address the development of CPC will be shared, along with the implementation of the public health model for palliative care development in relation to CPC globally. Studies looking at models of CPC service delivery will be discussed, along with examples of services, and the key elements of an effective CPC programme. Finally, the benefits of CPC will be discussed, along with some broad standards for CPC development, drawing upon work completed in different regions including Europe and Africa.

Results and Discussion

Whilst there is limited research on CPC, there is a growing evidence base, and this will demonstrate the value of citing CPC development within the Global Health Agenda such as the Sustainable Development Goals, Universal Health Coverage, the Astana declaration on primary health care, and the World Health Assembly resolution on palliative care. On the other side, development can be hindered through issues such as the opioids crisis in the US, and the implications to accessibility of medications for children’s palliative care. Whilst there is still a long way to go to ensure every child that needs it has access to palliative care, there is evidence of growth and developments. It is important that we learn from each other and share lessons learnt as there are many great examples of CPC provision globally. The key benefits of CPC are clear, and basic standards, both for service delivery and education exist and are useful as long as they are utilised appropriately within different culturally and resource contexts.

Conclusion

Much is happening in the global development of CPC and the global health environment such as universal health coverage, provides opportunities for ongoing development and strategizing so that no child or their family should suffer unnecessarily due to an absence of palliative care provision.