What is the value of palliative care provision in low-resource settings?

Increasing access to integrated ESKD care as part of universal health coverage

“…21,69,100 Work is needed to ensure a considered approach to the planning and delivery of ESKD care, to provide information and expert opinion to assist policy makers in deliberations concerning fairness in priority setting and resource allocation; and to promote shared and informed decision-making about management of kidney failure and provision of KRT in the context of health systems-including provision of appropriate supportive care for all patients, whether or not they receive dialysis. 70,[101][102][103] Sensitivity to global diversity in culture; consideration for special groups such as the underserved, indigenous populations, migrants and refugees; 104 and use of reliable evidence of kidney disease burden and capacity of health systems are imperative to inform ethical decisionmaking. 105 Evaluating practical issues identified above through an ethical lens is necessary to inform development of ethical frameworks to support decision-making, and to ensure that practical solutions are consistent with the values and preferences of the communities they are intended to benefit, as well as those responsible for their implementation.…”

“…21,69 Thus, even when there are few resource constraints directly influencing access to ESKD care, the potential benefits of various care modalities must be evaluated in comparison with the potential burdens and considered in the context of broader personal and societal goals. 77,103 Determining who should be involved in making such evaluations and how individuals or groups should be involved in decision-making requires careful ethical deliberation. Respect for autonomy is a widely accepted ethical norm in the context of health care delivery.…”

Palliative care within universal health coverage: the Malawi Patient-and-Carer Cancer Cost Survey

“…Evidence suggests that access to palliative care can reduce such catastrophic expenditure, though published data in this area are limited. 2 Universal Health Coverage (UHC) links quality and effectiveness of health services to end-user protection from financial hardship. It currently forms the key policy goal of the WHO.…”

Outpatient surgical care in sub‐Saharan Africa: Learning points for low‐ and high‐income settings

“…The current program relied on relatively passive management strategies (eg, wound surveillance and drain management), which was sufficient for these low‐intensity needs. When more complex wound care or hospice is required, many LMIC health systems lack the infrastructure to successfully meet patient and family needs in the home or outpatient environments . Much can be learned from well‐established programs in maternal and child health, HIV, and TB community care platforms in LMICs and rapidly evolving mHealth systems .…”

“…When more complex wound care or hospice is required, many LMIC health systems lack the infrastructure to successfully meet patient and family needs in the home or outpatient environments. 9 Much can be learned from well-established programs in maternal and child health, HIV, and TB community care platforms in LMICs and rapidly evolving mHealth systems. [10][11][12] Rather than ad hoc or reactionary creation of outpatient care systems to cope with overwhelmed hospital-based services, strategic investment should be made in outpatient management infrastructure to bring care to patients where they are most comfortable and more likely to succeed and to offload and improve the efficiency of hospital-based care.…”