Integrating palliative care and symptom relief into primary health care

Overview

The World Health Assembly has resolved that palliative care is “an ethical responsibility of health systems” and that integration of palliative care into public health care systems is essential for the achievement of the Sustainable Development Goal on universal health coverage (WHA 67.19).

Yet palliative care and symptom relief are rarely accessible in a number of countries. As a result, suffering on a massive scale remains unrelieved, and progress toward universal health coverage is at risk. The World Health Assembly also has called for Member States to “put people at the centre of health care” by providing “comprehensive primary care services, including health promotion, disease prevention, curative care and palliative care, that are integrated with other levels of care” (WHA 62.12).

The great majority of people who need palliative care prefer to remain at home, thus, it is medically and ethically necessary that palliative care be provided in the community, as part of primary health care. It is neither possible nor necessary that palliative care specialists provide most palliative care and symptom relief. Primary health care providers with basic training in palliative care and symptom relief can respond effectively to most palliative care needs and arrange for transfer to a higher level of care when necessary. Emphasis should be given to continuity of care, respect for patients’ values, equitable access to services, and attention not only to patients but also to their families. This manual is part of a series of WHO publications on palliative care.

Their objective is not to provide clinical guidelines, but rather practical guidance on integrating palliative care and symptom relief into health care systems. It is intended, to assist anyone involved with planning, implementing, managing or assuring the quality of PHC to integrate palliative care and symptom control. With this guide, WHO reiterates its commitment to answering the needs and expectations of all people, especially the most vulnerable.