Srinivasan Srikanth, Venugopal Vinayagamoorthy, Elayaperumal Suguna, Singh Mahendra, Kataria Priya, Radhakrishnan Rehana Vanaja
Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India.
Department of Community and Family Medicine, AIIMS, Deoghar, Jharkhand, India.
Indian J Community Med. 2024 Dec;49(Suppl 2):S164-S169. doi: 10.4103/ijcm.ijcm_758_24. Epub 2024 Dec 30.
Currently, access to palliative care is a challenge for the majority of people with serious health suffering in India. Most of the existing palliative care services are available at tertiary healthcare facilities in urban areas. The National Program of Palliative Care (NPPC) envisages incorporating palliative care in undergraduate medical education to improve the knowledge and skills of primary care physicians to provide quality palliative care in the home setting of patients. Additionally, NPPC also aims to promote community awareness and ownership in palliative care. Community-based palliative care (CBPC) provides holistic support for patients with serious illnesses. This position statement intends to address possible considerations on the role of the Indian Association of Preventive and Social Medicine (IAPSM) on CBPC in the country. A team of members of IAPSM trained in essential palliative care attempted to develop this position statement. The team explored the existing status of palliative care in India and feasible solutions through IAPSM for CBPC by the objectives of NPPC. The team applied and analyzed the WHO framework of public health approach to palliative care - amalgamation in primary health care, integration with specialists for continuum of care, public awareness, training of primary care physicians and community volunteers, and supportive supervision in community initiatives. IAPSM can effectively contribute to CBPC through capacity building of the primary health care team, awareness generation, promoting community ownership, and development of standards of care through community-based research. Implementing the aforementioned recommendations would contribute to achieving the target of Sustainable Development Goal 3.8, which addresses the need for pain relief and palliative care to all needy patients. The IAPSM recognizes palliative care as a vital component of Universal Health Coverage and holds the capacity to bring about substantial changes in the promotion of CBPC in India.
目前，对于印度大多数患有严重健康问题的人来说，获得姑息治疗是一项挑战。现有的大多数姑息治疗服务都在城市地区的三级医疗机构提供。国家姑息治疗计划（NPPC）设想将姑息治疗纳入本科医学教育，以提高初级保健医生在患者家庭环境中提供优质姑息治疗的知识和技能。此外，NPPC还旨在提高社区对姑息治疗的认识并增强社区在姑息治疗方面的主人翁意识。基于社区的姑息治疗（CBPC）为重病患者提供全面支持。本立场声明旨在探讨印度预防与社会医学协会（IAPSM）在该国CBPC中所扮演角色的可能考量因素。一组接受过基本姑息治疗培训的IAPSM成员试图制定本立场声明。该团队通过NPPC的目标，探索了印度姑息治疗的现状以及IAPSM在CBPC方面可行的解决方案。该团队应用并分析了世界卫生组织关于姑息治疗公共卫生方法的框架——融入初级卫生保健、与专科医生整合以实现连续护理、公众意识、初级保健医生和社区志愿者培训以及社区倡议中的支持性监督。IAPSM可以通过加强初级卫生保健团队的能力建设、提高认识、促进社区主人翁意识以及通过基于社区的研究制定护理标准，有效地为CBPC做出贡献。实施上述建议将有助于实现可持续发展目标3.8的目标，该目标涉及为所有有需要的患者提供疼痛缓解和姑息治疗。IAPSM将姑息治疗视为全民健康覆盖的重要组成部分，并具备在印度促进CBPC方面带来重大变革的能力。
