Palliative Care: an approach to comprehensive care in Universal Health Coverage

This article was exclusively written for The European Sting by Ms. Larissa Sena de Lucena, a 4th year medical student at UNIFAP-Macapá and Ms. Anna Valeska Procópio de Moura Mendonça, a psychologist and professor in the Medicine course at the Federal University of Amapá. 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.

Universal Health Coverage (UHC) was shaped by the World Health Organization (WHO), in the period from 2004 to 2011, and constitutes guidelines that prioritize the promotion of health policies¹ aimed mainly at welcoming vulnerable population groups² in health care systems health, seeking to provide access to the services available, as recommended by WHO³.

For the realization of the human right to health, interventions that seek to universalize access and coverage of health in an integral and quality way are necessary to address the social determinants of health4, such as the reduction of poverty and social inequality5. Therefore, it is necessary to reduce barriers to access and offer comprehensive care that meets the health needs of the population, to improve the well-being of individuals, especially those facing progressive diseases that threaten the continuity of life.

In this scenario, considering that palliative care (PC) consists of the ethical responsibility of health systems6, this form of assistance still presents a relevant disparity in health care worldwide7, as few countries have health and health education policies that apply for this support in the face of an incurable disease in an effective way8, making its insertion urgent and immediate, since it build-ups and expands the panorama of coping with clinical conditions that cannot be cured, starting from the diagnosis and following the evolution of the disease9. Also, it acts in solving problems in several axes, such as in the physical, psychosocial and spiritual sphere10 as well as, its actions act in the grieving process and extends the care not only to the patient but also to the family members.

Another important perspective to reinforce the implementation of care is the global epidemiological and age transition. Bearing in mind that the population aging rhythm is accelerated11 with increased life expectancy8 and the most prevalent diseases started to have a chronic-degenerative character or also called non-transmissible chronic diseases (NCDs), such as cardiovascular, respiratory pathologies chronic diseases, cancers, and diabetes, responsible for more than 70% of deaths worldwide. Illnesses in NCDs are the main public health problem12, as progressive and debilitating sequelae may arise, causing varying degrees of dependency in patients. Thereby, PCs play an essential role in the clinical history, showing relevance in the late stages and complications13.

Consequently, the implementation of this comprehensive care proposal is necessary and contributes to the qualification of health care and the promotion of its coverage in the nations of the world. In this sense, it seeks to promote equity in access to resources, as well as vulnerability reduction policies for the full implementation of this fundamental guarantee of life, which is the right of every citizen.

REFERENCES

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About the authors

Larissa Sena de Lucena, is a 4th year medical student at UNIFAP-Macapá, from Amapá/AP, affiliated with IFMSA-UNIFAP since 2017. She is a local coordinator of IFMSA-UNIFAP and affiliated with the Academic League of Internal Medicine of Amapá, she is interested in issues about palliative care, humanized medicine, care for terminal patients, besides scientific initiation. 

Anna Valeska Procópio de Moura Mendonça is a psychologist and professor in the Medicine course at the Federal University of Amapá. Coordinator of the Laboratory for the Study of Death and Palliative Care.