Primary Care: a way to provide Palliative Care in Universal Health Coverage

(Credit: Unsplash)

This article was exclusively written for The European Sting by Ms. Celina Maria de Carvalho Guimarães and Maria Brenda Clemente Lima, two 21 years old second year medical student at Universidade de Pernambuco, Recife. They are 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 writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

The World Health Organization (WHO) says that the Palliative Care (PC) is an approach to promote a better quality of life for the patient and their family. It not only involves physical health, but also includes the psychosocial and the spiritual life. It is important to endorse that this system embraces all ages, requires multiprofessional support and has been considered as an essential part of the health process that cannot be neglected. In Brazil, the PC has been applied since the end of the 90’s and in 2017 it reached the 3B level in Development of Palliative Care, which means that it has an important level of PC services but there are some lacks on its coverage and initiatives, like training and education.

Universal Health Coverage (UHC) is a WHO’S definition about the health services’ availability for all individuals and communities without the need of a substantial amount of financial resources. It should involve every level of care: promotion, prevention, treatment and rehabilitation, including the PC. Despite that, the efficient PC’s coverage is not a reality for major countries. According to PC 2017 Mapping Levels, only 14% of the global population has access to the highest level of Palliative Care Provision and those are concentrated in European countries. This data expresses there is a relevant gap within this area and different strategies are required to insert PC more effectively in UHC.

To understand what are the best strategies for achieving this goal, it’s important to say that the UHC itself isn’t a reality for major countries, and PC, as a part of that, it’s far from being included in an expressive approach. Despite that, the benefits of CP are very expressive for every level of the health system. For the patients, researches have shown how posite are the effects of early PC on the treatment of several illnesses, and that there will be an increasing demand for that, exemplified by chronic and non communicable diseases combined to population aging.

In this thought, a way to ensure PC in UHC is to offer it in Primary Care. This is fundamental because it is the society’s closest access to the health services, especially to ones with low mobility, and it may also promote attendance decentralization, which can improve the service quality. To ensure that, it’s relevant to create and apply public politics related to PC, as it occured through a 2018 resolution in Brazilian Unified Health System, which guides PC inclusion in public care.

Some advantages to enforce PC in Primary Care are to assure a singular terapeutic project to the patients, based on their characteristics and needs. If it were combined to prepared health care teams near to their residences, the attention could be facilitated by becoming the home a place of assistance.

Therefore, one way to ensure PC in the UHC is finding a space for it in Primary Care, making sure that the population has this service available close to them.


BRASIL. Resolução nº 41, de 31 de outubro de 2018. Dispõe sobre as diretrizes para a organização dos cuidados paliativos, à luz dos cuidados continuados integrados, no âmbito Sistema Único de Saúde (SUS). Diário Oficial da União: seção 1, Brasília, DF, 23 nov. 2018. Available from: Access on : 22 dez. 2020.

CLARK, D. et al. Mapping levels of palliative care development in 198 countries: the situation in 2017. Journal of Pain and Symptom Management, v. 59, n. 4, p. 794- 807.e4, abr. 2020.

GOMES, A. L. Z. et al. Cuidados paliativos. Estudos Avançados, v. 30, n. 88, p. 155–166, dez. 2016.

MARCUCCI, F. C. I. et al. Identification and characteristics of patients with palliative care needs in Brazilian primary care. BMC Palliative Care, v. 15, 1 jun. 2016.

Universal health coverage (Uhc). Available from: <;. Access on: 23 dez. 2020.

About the author

Celina Maria de Carvalho Guimarães is a Brazilian 21 years old second year medical student at Universidade de Pernambuco, Recife. She is a member of IFMSA Brazil (International Federation of Medical Students’ Associations – Brazil).

Maria Brenda Clemente Lima is a Brazilian 21 years old third year medical student at Universidade de Pernambuco, Recife.

the sting Milestones

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

EU Budget 2020 conciliation talks suspended

Eurozone’s north-south growth gap to become structural

Air pollution: Most EU Member States not on track to reduce air pollution and its related health impacts by 2030

New Disability Inclusion Strategy is ‘transformative change we need’, says Guterres

These are the countries best prepared for the fight against cancer

Prospect of lasting peace ‘fading by the day’ in Gaza and West Bank, senior UN envoy warns

Security Council approves ‘historic’ political Haiti mission, ending UN peacekeeping role in the country

Learning lessons from across Europe – the hidden costs of COVID-19 on lung cancer

Why ‘video call fatigue’ might be making you tired during lockdown – and how to beat it

What is tuberculosis and why are deaths rising?

Mergers: Commission waives the commitments made by Takeda to obtain clearance of its acquisition of Shire

10 ways COVID-19 could reshape offices

The US calls off globalization, targets Germany. Paris offer to Berlin comes at a cost

4 lessons on human cooperation from the fight against Ebola

Collaboration and connectivity at ITU Telecom World 2019

‘Revved up climate action’ needed to counter ‘prolonged’ and deadly storms like Cyclone Idai: Guterres

Here’s how data can shine a light on financial crime

What does artificial intelligence do in medicine?

Parliament to ask for the suspension of EU-US deal on bank data

Progress made at COP25, despite lack of agreement to increase climate ambition

UN ‘prioritizing needs’, ramping up aid, as Hurricane Dorian continues to batter the Bahamas

Countries must invest at least 1% more of GDP on primary healthcare to eliminate glaring coverage gaps

Brexit: the time has come for the UK to clarify its position

Starbucks and FIAT again under Commission’s microscope: is Europe ready to kick multinationals out of the house?

Why we need a blockchain bill of rights

India vs Virus: voices from the COVID front line

How the tech sector can power the shift to a sustainable economy

UN chief welcomes G20 commitment to fight climate change

Are we at risk of a financial crisis? Our new report takes a look

Antitrust: Commission sends Statement of Objections to Conserve Italia for participation in canned vegetables cartel

iSting: a reader’s thoughts on the UN Environment Assembly 2017

With 5 billion set to miss out on health care, UN holds landmark summit to boost coverage

Antitrust: Commission fines Google €1.49 billion for abusive practices in online advertising

Essential services on verge of shutdown in Gaza as emergency fuel set to run out

Here are three technology trends changing the way you travel

The EU Parliament sidesteps the real issues about banks, while the US target the Eurozone lenders

5 crises that could worsen under COVID-19

How can we make enough vaccine for 2 billion people?

China, forever new adventures

Quality Internships: Towards a Toolkit for Employers

Who cares about the unity of Ukraine?

YouTube stars get creative at UN, to promote tolerance

These Dutch tomatoes can teach the world about sustainable agriculture


A Sting Exclusive: “Education in Europe, fostering skills development inside and outside the school system”

How the mobile industry is driving climate progress on the scale of a major economy

EU defence gets a boost as the European Defence Fund becomes a reality

How the Belt and Road Initiative could support an ageing population

Better understanding the psychological impact caused by the COVID-19 Pandemic

Our poisonous air is harming our children’s brains

EU legislation protecting home buyers approved in Parliament

Does the West play the Syrian game in Egypt?

Normal reactions to the abnormality of the pandemic

How climate change sparks innovation for fragile communities

Thai cave boys spared thundershowers, highlighting extreme climate disruption: UN weather agency

Batteries included: how better storage can transform renewable energy

Eurozone stagnates after exporting its recession to trading partners

Why the euro may rise with the dollar even at lower interest rates

New Eurobarometer survey shows: The majority of Europeans think the EU should propose additional measures to address air quality problems

We must stop turning a blind eye to the world’s health crises

Living in a pandemic: what are the effects of COVID-19 on the mental health of the youth?

More Stings?


  1. MDOfficeManager says:

    Thanks for sharing this valuable information.

Speak your Mind Here

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: