Abstract
With the rise in cancer burden, need for palliative care services has increased simultaneously and majority of people requiring services are from low- and middle-income countries where palliative care is in primitive stage. Nepal is also facing similar challenges of dealing with cancer care and end-of-life care. From its initiation in the early 1990s, there has been gradual progress in the development of palliative care with joint effort of government as well as non-governmental organizations. Morphine, a major milestone for pain management, is being manufactured in the country for nearly a decade, yet morphine equivalence mg per capita is far below the global average. Currently, Nepal has been placed under ‘Category 3a’ with isolated care provision and there are a lot of challenges to overcome to improve the existing services. Majority of hospice and palliative care centres are located in the capital city and only a few in the periphery. Scarcity of treatment centres and expertise, limited finances, lack of awareness among patients and health care workers, and difficult terrain are major barriers for optimal care. Proper implementation of national guidelines, human resource development and integration of palliative care to primary healthcare level would be crucial steps for further improvement.
Highlights
Burden of non-communicable diseases including cancer is rising every year worldwide and this has brought further constraint in the developing countries with limited health resources.[1]
Koirala Memorial Cancer Hospital, Bharatpur 44207, Nepal. gautamdeepa09@yahoo. com Sudhir Adhikari Department of Paediatrics, Chitwan Medical College, Bharatpur, Nepal an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.[4]
The increasing cancer burden in Nepal has led to the rise in patients requiring palliative care
Summary
Burden of non-communicable diseases including cancer is rising every year worldwide and this has brought further constraint in the developing countries with limited health resources.[1]. Development of palliative care Worldwide, focus towards modern palliative care in the form of pain management and end-of-life care needs of the patients with advanced stage cancer was initiated in the late 1960s and about a decade later, it expanded to include the psychosocial and the spiritual care as well. Education and training The Nepalese Association of Palliative Care (NAPCare), a non-profit non-governmental organization was established in 2009, to improve palliative care services in the country and to create awareness and educate the healthcare personnel about palliative care.[20] NAPCare has developed the National Strategy for Palliative Care, which focuses on pain management in coordination with Ministry of Health (MoH) and WHO with support from Two Worlds Cancer Collaboration, Canada.[17,20,21].
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