Palliative care and Universal Health Coverage: Do not leave those suffering behind

This article was exclusively written for The European Sting by Mr. Goodluck Issa Nchasi, a 3^rd  year medical student at Catholic University Of Health And Allied Sciences (CUHAS), faculty of Medicine, located in Mwanza, Tanzania. He 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.

A famous quote by Martin Luther King says” Of all the forms of inequality, injustice in health care is the most shocking and inhuman.” Universal health coverage (UHC) means that all people have access to the health services they need, when and where they need them, without financial hardship. Currently, at least half of the people in the world do not receive the health services they need. About 100 million people are pushed into extreme poverty each year because of out-of-pocket spending on health.(1)

UHC can be achieved by improving health service coverage and health outcomes which depends on the availability, accessibility, and capacity of health workers to deliver quality people-centred integrated care that also includes palliative care, which aims to improve the quality of life of adults and children living with and dying from life limiting conditions including non-communicable diseases such as cancer and heart disease and communicable conditions such as HIV and multi-drug resistant TB.  

Palliative care is a needed and essential health service within the definition of Universal Health Coverage. The World Health Organization (WHO) emphasizes on how crucial palliative care is in relieving the patient’s suffering, be it physical, psychological, social or spiritual. Studies show that about 40 million people need palliative care each year and less than 10% of people who need palliative care in low and middle-income countries actually receive it.(2) The Figure below was published in the Global Atlas in 2012 showing the estimated numbers of patients receiving palliative care in different countries worldwide

The need for access to palliative care services as a key part of Universal Health Coverage can be advocated by including palliative care within health insurance and financial protection schemes. The World Hospice Palliative Care Alliance (WHPCA) conducted a rapid survey of organizations and individuals engaged in palliative care globally. There were 70 responses from 43 countries. Feedback was collated and analysed to provide one combined response per country. 79% (34) of the country respondents stated that the government had free health care or health insurance schemes. 16% (seven respondents) stated that their government did not have free health care or health insurance schemes. 5% (two respondents) did not know or did not answer.(3)

Palliative care is important because it gives patients an option for pain and symptom management and higher quality of life while still pursuing curative measures. We should remember that “There is an end to cure; there is no end to care.”

References

1. Organization WH. Universal health coverage (UHC) 24 January 2019 [Available from: https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc).

2. Organization WH. Palliative Care 5 August 2020 [Available from: https://www.who.int/news-room/fact-sheets/detail/palliative-care.

3. Alliance WHPC. Universal Health Coverage and Palliative Care. 2014.

About the author

My name is Goodluck Issa Nchasi, I am a 3^rd  year medical student at Catholic University Of Health And Allied Sciences (CUHAS), faculty of Medicine, located in Mwanza, Tanzania. I am also a member of Tanzania Medical Students Association (TAMSA), as the former national and local officer of SCORE – Standing Committee on Research Exchange. I love sharing my ideas through writing medical and research articles. I also have great enthusiasm towards research since it shows us our faults and how to improve so as to ensure a better global health-care.