Integrating Palliative Care and Symptom Relief into Primary Health Care: A Who Guide for Planners, Implementers and Managers. Geneva: World Health Organization; 2018
(2018; 88 pages)


Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care. Currently, there is avoidable suffering on a massive scale due to lack of access to palliative care and symptom relief in low- and middle-income countries (LMICs). Yet basic palliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is “an ethical responsibility of health systems”. Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC). This second in a series of World Health Organization (WHO) guides on palliative care follows a general one entitled Planning and implementing palliative care services: a guide for programme managers, published in 2016. The current document may be used by itself for integrating palliative care into primary care or in combination with the earlier guide by those working to integrate palliative care into multiple levels of a health care system. This document is not a clinical manual, and does not provide clinical guidelines. Rather, it contains detailed information about what palliative care is and should be, the rationale for it being a medical and moral imperative, an Essential Package of Palliative Care for Primary Health Care (EP PHC) and a method for implementing palliative care within primary care in a way that strengthens health care systems. It represents the collective knowledge, experience and recommendations of a group of experienced palliative care clinicians, all of whom either are also primary care clinicians or work in LMICs, or both.

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