Downing Julia, Boucher Sue, Daniels Alex, Nkosi Busi
International Children's Palliative Care Network, Assagay 3624, South Africa.
Children (Basel). 2018 Feb 19;5(2):27. doi: 10.3390/children5020027.
There is a great need for paediatric palliative care (PPC) services globally, but access to services is lacking in many parts of the world, particularly in resource-poor settings. Globally it is estimated that 21.6 million children need access to palliative care, with 8.2 needing specialist services. PC has been identified as important within the global health agenda e.g., within universal health coverage, and a recent Lancet commission report recognised the need for PPC. However, a variety of challenges have been identified to PPC development globally such as: access to treatment, access to medications such as oral morphine, opiophobia, a lack of trained health and social care professionals, a lack of PPC policies and a lack of awareness about PPC. These challenges can be overcome utilising a variety of strategies including advocacy and public awareness, education, access to medications, implementation and research. Examples will be discussed impacting on the provision of PPC in resource-poor settings. High-quality PPC service provision can be provided with resource-poor settings, and there is an urgent need to scale up affordable, accessible, and quality PPC services globally to ensure that all children needing palliative care can access it.
全球对儿童姑息治疗(PPC)服务有巨大需求,但世界许多地区,尤其是资源匮乏地区,缺乏获得此类服务的途径。据全球估计,有2160万儿童需要获得姑息治疗,其中820万需要专科服务。姑息治疗在全球卫生议程中已被视为重要内容,例如在全民健康覆盖范围内,最近《柳叶刀》委员会的一份报告也认识到了儿童姑息治疗的必要性。然而,全球儿童姑息治疗发展面临各种挑战,如:获得治疗的机会、获得口服吗啡等药物的机会、对阿片类药物的恐惧、缺乏训练有素的卫生和社会护理专业人员、缺乏儿童姑息治疗政策以及对儿童姑息治疗缺乏认识。可以通过多种策略克服这些挑战,包括宣传和提高公众意识、教育、获得药物、实施和研究。将讨论在资源匮乏地区影响儿童姑息治疗提供的实例。在资源匮乏地区也可以提供高质量的儿童姑息治疗服务,全球迫切需要扩大负担得起、可获得且高质量的儿童姑息治疗服务,以确保所有需要姑息治疗的儿童都能获得该服务。