Palliative care and Universal Health Coverage: how to advocate for the inclusion of palliative care in UHC

This article was exclusively written for The European Sting by Ms. Mary AlMadani, a 3rd-year medical student at Mutah University, Jordan. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Our population is getting older and sicker. More people are facing life-threatening illnesses which could affect them financially, as they are either unable to work due to their condition, or family members are unable to work due to their caring responsibilities. Now, palliative care has grown to meet the complex needs of this population.

Upon the increase of non-communicable and chronic diseases, Universal Health Coverage aims to ensure that countries develop a universally accessible health system for all citizens that meets population health needs and priorities. Palliative care is an essential and needed health care service within Universal Health Coverage which focuses on meeting the needs of the whole person not just treating their medical condition from pre-natal to death. Pain management is considered to be a key part of hospice and palliative care as it is one of the most common and distressing symptoms that people with serious illness and those at the end of their life face.

Palliative care is a human right, all people should have access to it with insuring fairness and equity .Unfortunately, health care services are far from being integrated in many health systems of many countries around the world. Lack of access to opioid analgesics especially morphine is a particularly challenging issue which poses a barrier to Universal Health Coverage. The easiest and most simple way to relieve pain is by using oral morphine which is unfortunately rarely available in many countries due to myths of addiction or acknowledging the proper use of opioid medications.

The main factor that causes the lack of integration of palliative care in to the UHC of many countries is due to the lack in the numbers of health care workers in palliative care in addition to the lack of education, training and integration of palliative care in health professional curricula.

There is an increasing evidence on the cost effectiveness of the palliative care, however, the differing costs of different service delivery methods and its overall cost-effectiveness may result in challenges to palliative care implementation as part of Universal Health Coverage.

All in all, people with or dying from life limiting conditions should all have access to palliative care system despite their ages without entering into financial hardships. It should be a central component of any health care system and included within Universal Health Coverage schemes and governments should improve the  availability and accessibility of hospice and palliative care services including access to medications for pain management and access to services in all settings where it is needed, including the home.

As Ann Richardson once said:”We cannot change the outcome but we can affect the journey.”

About the author

This article was exclusively written for The European Sting by Ms. Mary AlMadani, a 3rd-year medical student at Mutah University, Jordan. Currently, she is the president of Mutah University Local Committee at IFMSA-JO. She has been an active member in the federation since 2018 and participated in many regional, national and international workshops. Her message is that change is the key to achieve progress in our lives.