Palliative care must be strengthened in India

Source: The post Palliative care must be strengthened in India has been created, based on the article “Integrating compassion, prioritising palliative care” published in “The Hindu” on 3rd July 2025

UPSC Syllabus Topic: GS Paper 2 – Issues relating to development and management of Social Sector/Services relating to Health.

Context: Millions in India endure avoidable suffering due to the lack of palliative care. Despite its ability to provide comfort and dignity during terminal illness, this form of care remains underfunded and underused. The article explores the barriers, current efforts, and urgent need for its integration into India’s health-care system.

For detailed information on Palliative care read this article here

Understanding the Role and Scope of Palliative Care

1. Definition and Purpose: Palliative care is specialised support that addresses a patient’s physical, emotional, social, and spiritual needs. Unlike curative treatment, it focuses on relieving pain, reducing suffering, and improving quality of life for patients and families.
2. Global and Indian Demand: According to the WHO, 40 million people globally need palliative care each year, with 78% in low- and middle-income countries. Yet only 14% receive it. In India, an estimated 7 to 10 million people need it annually, but only 1%-2% have access.
3. Growing Need with Non-Communicable Diseases: Rising cases of cancer, diabetes, and chronic respiratory diseases increase the demand. India’s overburdened health-care system requires palliative care to minimise hospital visits and reduce emotional and financial burdens on families.

Challenges Hindering Palliative Care in India

1. Unequal Access Despite Policy Inclusion: The inclusion of palliative care in the National Health Policy 2017 was significant. However, access remains uneven, especially in rural and low-income areas. An estimated 7.2 million Indians need such care each year, but systemic inefficiencies persist.
2. Shortage of Specialised Professionals: Although India’s doctor-population ratio is 1:834 (better than WHO’s 1:1000 norm), very few doctors are trained in palliative care. This hampers pain management and end-of-life services.
3. Limited Resources and Awareness: Inadequate funding, poor infrastructure in tertiary care, and low public awareness hinder timely care. Misconceptions lead to delayed or no access to these essential services.

Integrating Palliative Care into Medical Education and Workforce

1. Curriculum Integration for Doctors: Adding palliative care to the MBBS curriculum can train doctors in compassion and terminal care. Initiatives by AIIMSand ICMR reflect gradual improvements.
2. Empowering Health-Care Workers: With 34.33 lakh nurses and 13 lakh allied health professionals, India has a strong base. Task-shifting—training this workforce—can expand access, especially in underserved areas.
3. Policy-Level Support and Insurance: Governments should allocate funds, improve infrastructure, and ensure palliative care is included in schemes like Ayushman Bharat. Collaboration with NGOs and private bodies can accelerate delivery.

Raising Awareness and Learning from Global Models

1. Promoting Public Understanding: Awareness campaigns can clarify the scope of palliative care. It is not just end-of-life care, but also includes pain relief and psychological support during chronic illness. Educating communities early can lead to timely care and influence policy reform.
2. Adapting Global Best Practices: The U.S. model demonstrates how strong funding, insurance, and hospice care support quality end-of-life services. India can draw lessons while adapting them to its economic, demographic, and cultural realities.
3. Towards a Comprehensive Reform Agenda: Evidence-based, context-sensitive strategies are crucial to improve palliative care. India must adopt a multi-pronged approach: integrate palliative care in medical education, empower allied health professionals through task-shifting, invest in public infrastructure, and raise awareness. This will ensure compassionate, patient-centered care and reduce the burden on families and the health-care system.

Question for practice:

Discuss the major challenges and necessary reforms for integrating palliative care into India’s health-care system.