Mark R. Steedman (
Thomas Hughes-Hallett is chair of the End of Life Care Forum at WISH, Qatar Foundation, and executive chair of the Institute of Global Health Innovation, Imperial College London.
Health Aff (Millwood). 2014 Sep;33(9):1612-9. doi: 10.1377/hlthaff.2014.0379.
Provision for end-of-life care around the world is widely variable and often poor, which leads to millions of deaths each year among people without access to essential aspects of care. However, some low- and middle-income countries have improved specific aspects of end-of-life care using innovative strategies and approaches such as international partnerships, community-based programs, and philanthropic initiatives. This article reviews the state of current global end-of-life care and examines how innovation has improved end-of-life care in Nigeria, Uganda, India, Bangladesh, Myanmar, and Jordan. Specifically, we examine how opioids have been made more available for the treatment of pain, and how training and education programs have expanded the provision of care to the dying population. Finally, we recommend actions that policy makers and individuals can take to improve end-of-life care, regardless of the income level in a country.
全球各地的临终关怀服务差异很大，而且往往很差，这导致每年都有数百万人因无法获得基本的临终关怀而死亡。然而，一些低收入和中等收入国家已经通过创新战略和方法，如国际合作、社区项目和慈善举措，改善了临终关怀的某些特定方面。本文回顾了当前全球临终关怀的状况，并探讨了创新如何改善尼日利亚、乌干达、印度、孟加拉国、缅甸和约旦的临终关怀服务。具体而言，我们研究了如何使阿片类药物更易于获得，以治疗疼痛，以及培训和教育计划如何扩大为临终人口提供的护理范围。最后，我们建议政策制定者和个人可以采取行动，无论一个国家的收入水平如何，都可以改善临终关怀服务。
