Phan Huu Hung, Gandhi Ishita
Department of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
Director - Palliative Medicine, CanSupport, New Delhi, India.
J Cancer Policy. 2025 Sep;45:100612. doi: 10.1016/j.jcpo.2025.100612. Epub 2025 Jul 11.
As of April 2023, India is reported to be the most populated country in the globe by the United Nations, with estimation of around 1.5 billion citizens. Despite the development in palliative delivery in recent years, access to such services in rural populations remains underutilized and shows many difficulties. As life expectancy increases, those who live in rural areas are faced with higher incidences of non-communicable diseases along with the already burdened prevalence of infectious diseases, leading to an ever-high demand for end-of-life healthcare services that are easy to access and affordable.
To identify strategies to enhance care quality and ways to raise community awareness of the importance of end-of-life healthcare services by systematically addressing the challenges in palliative care delivery in remote communities in India.
We conducted a scoping review using PubMed, EMBASE, Cochrane Library and Web of Science databases following PRISMA guidelines up to February 2024 focusing on palliative care delivery and quality improvement in rural Indian communities, aligning WHO ICCCF elements.
From 366 records, 22 papers met the inclusion criteria and were synthesized. 16 articles discussed care model implementation, 3 focused on awareness and education, and 3 analyzed policy challenges. Barriers identified include geographical, socioeconomic, and workforce challenges, alongside cultural misconceptions. Strategies proposed involve comprehensive training, community engagement, and policy reforms.
Addressing palliative care barriers in rural India requires improving infrastructure, expanding the healthcare workforce, and fostering cultural sensitivity. Community involvement and strategic collaboration are vital for enhancing access and quality of care.
据联合国报告，截至2023年4月，印度是全球人口最多的国家，估计有15亿公民。尽管近年来姑息治疗服务有所发展，但农村人口对这类服务的利用率仍然很低，且存在诸多困难。随着预期寿命的增加，农村地区居民面临着更高的非传染性疾病发病率，同时传染病患病率本就居高不下，这导致对易于获得且负担得起的临终医疗服务的需求不断攀升。
通过系统应对印度偏远社区姑息治疗服务提供方面的挑战，确定提高护理质量的策略以及提高社区对临终医疗服务重要性认识的方法。
我们按照PRISMA指南，使用PubMed、EMBASE、Cochrane图书馆和科学网数据库进行了一项范围综述，截至2024年2月，重点关注印度农村社区的姑息治疗服务提供和质量改进，与世界卫生组织国际综合关怀中心的要素保持一致。
从366条记录中，有22篇论文符合纳入标准并进行了综合分析。16篇文章讨论了护理模式的实施，3篇关注意识和教育，3篇分析了政策挑战。确定的障碍包括地理、社会经济和劳动力方面的挑战，以及文化误解。提出的策略包括全面培训、社区参与和政策改革。
应对印度农村地区的姑息治疗障碍需要改善基础设施、扩大医疗劳动力队伍并增强文化敏感性。社区参与和战略协作对于提高服务可及性和护理质量至关重要。
