The importance of including palliative care in the Universal Health Coverage and how to achieve it

This article was exclusively written for The European Sting by Mr. Strahil Vasilev, a 22 years old, fifth year Medical student in Medical University of Sofia, Bulgaria. He is affiliated with 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.

Since 1883, when the first step towards health coverage for everyone in need was made, we have seen an amazing development in the Universal Health Coverage (UHC) system. [1] UHC is defined as ensuring that all people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship. [2]

Although palliative care is included in the definition of UHC, still the main attention of the health system is towards the acute illnesses and the focus is on a specific component (treatment) rather than the whole continuum, leading to neglecting important parts of the health care. [3] Palliative care is provided by multidisciplinary teams and it aims to improve the quality of life of everyone living or dying with life limiting conditions. [5]

In today’s world, medicine is on a high level and this leads to a longer lifespan, but with it comes the more illnesses, because the longer the person lives, the more chance of him living with a disease of some kind. In the last few years a rise in the chronic condition has been observed, which makes palliative care a really important part of medicine and health care. People with serious health related suffering worldwide are 61.5 million. [6] Palliative care will be beneficial for everyone, because it is proven that care of this kind can improve the quality of life for these people and improving their quality of life is essential, since curing them is impossible. If palliative care is fully included in the UHC, it will increase the quality of life of ill people, mainly at the end of their life, it will reduce their financial burden and alleviate their pain. [4] Palliative care should be a main part of UHC and a central component of every country’s health system. [5]

With all that said, the way we can advocate for the inclusion of palliative care in UHC is by making distinct strategies and plans on a local, national and global level. Key component should be connecting patients with the government to work and raise awareness about the problem in the society. People and associations should actively promote palliative care as a service that must be free of charge and universally available. Palliative care should be included in the training of the social and health care workers. A rigorous and robust research in the field of cost-effectiveness, data collection and monitoring of the unbiased coverage of palliative care. [5,6]

“I regard universal health coverage as the single most powerful concept that public health has to offer. It is inclusive. It unifies services and delivers them in a comprehensive and integrated way, based on primary health care.”

Margaret Chan – WHO Executive Director

References

1 – Wikipedia contributors. Universal health care. Wikipedia, The Free Encyclopedia. December 21, 2020, 04:31 UTC. Available at: https://en.wikipedia.org/w/index.php?title=Universal_health_care&oldid=995464896. Accessed December 21, 2020.

2 – World Health Organization, World Bank. Tracking universal health coverage: first global monitoring

report. Geneva: WHO; 2015 Jun.

3 – Knaul FM, Bhadelia A, Atun R, Frenk J. Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses. Health Aff (Millwood). 2015;34(9):1514-1522. doi:10.1377/hlthaff.2015.0514

4 – Adithyan GS, Jose A. The Importance of Integrating Palliative Care in Universal Health Coverage Discourse in India. Indian J Community Med. 2018;43(4):320-321. doi:10.4103/ijcm.IJCM_304_17

5 – http://www.thewhpca.org/images/resources/publications-reports/Universal_health_coverage_report_final_2014.pdf

6 – Knaul FM, Farmer PE, Krakauer EL, et al. Alleviating the access abyss in palliative care and pain relief-an imperative of universal health coverage: the Lancet Commission report [published correction appears in Lancet. 2018 Mar 9;:]. Lancet. 2018;391(10128):1391-1454. doi:10.1016/S0140-6736(17)32513-8

About the author

Strahil Vasilev is 22 years old, fifth year Medical student in Medical University of Sofia, Bulgaria. He has been a volunteer at Acibadem City Clinic, Cardio-vascular center, since 2019. He is a member of the Association of Medical Students in Bulgaria, Ambassador for Juvenes Pro Medicina and Ambassador for Antwerp Medical Student’s Congress. His main interests are cardiology, chronic cardiovascular diseases -prevention, treating and burden.