Work

SINCE 2015

India

Growing palliative care access in the world’s most populous country

country updates

My biggest satisfaction is I started with 1 doctor, myself, with 3 residents, and now we have a big department of 67 residents in 14 faculties. We have started a dedicated MD palliative care programme and taught so many doctors in other branches at the hospital too.
Dr Sushma Bhatnagar
Professor and Head of Anesthesiology, Pain and Palliative Care
All India Institute of Medical Sciences, India

Our IMpact

228

Participants

trained in palliative care services

62

Institutions

involved in palliative care training

Over the years, we have helped the following institutes across India develop palliative care services:

We have more and more centres now having palliative care—medical colleges, district hospitals, cancer hospitals—which would not have been possible without the CTC training programme. Even in the remote parts of India where palliative care has never reached, such as Arunachal Pradesh and Kashmir… And that is where I think the benefit of the programme comes in.
Dr Seema Rao
Palliative Care Consultant

Among India’s population of 1.3 billion, around 6 million are estimated to need palliative care every year. This has traditionally been provided by non-governmental organisations, which are accessible to less than 2 percent of the population since they are community-led and home-based. The effort is also uneven as over 90 percent of the estimated 1,000 palliative care units are located in the state of Kerala. Although palliative care services have grown since India recognised it as a medical specialty in 2012, they are still insufficient to bring relief to the millions of Indians dying from non-communicable diseases each year.

Our work to improve palliative care access in India started in March 2015 with our collaboration with the All India Institute of Medical Sciences (AIIMS), a group of government medical universities that runs a nation-wide network of Cancer Treatment Centres (CTC). The aim was to impart palliative care skills to the primary team physicians of chronic disease patients, and make oral morphine available in at least 100 of the 327 CTCs. As of 2022, our programme has helped establish palliative care services in over 62 CTCs.

Participants of our fourth foundation courses in palliative care services in 2020.

In 2019, we also partnered Kasturba Medical College, Manipal, to expand the programme’s reach. Our work at AIIMS has also helped the institute become designated by the World Health Organization (WHO) as a WHO Collaborating Centre for Training and Education in Palliative Care in 2022. Most recently, a report on our programme has been published in the peer-reviewed BMC Palliative Care journal.

I've collaborated with Lien Collaboration since 2015 and from then on it's been no looking backwards. I'm proud of the work we have done and it aligns with my personal belief of transformation. We were able to transform the palliative care story in India. The entire narrative has changed.
Dr Naveen Salins
Professor and Head of the Department of Palliative Medicine, Kasturba Medical College, Manipal

On the Ground

Key Achievements

Kasturba Medical College is a WHO Collaborating Centre for Training and Education in Palliative Care

The programme’s country leads are:

Dr Sushma Bhatnagar (India)
Dr Naveen Salins (India)
Dr Shirlynn Ho (Singapore)

Institutions trained by the CTC programme are equipped with the knowledge and skills to:
  • Start a palliative care and pain management programme
  • Run a round-the-clock palliative care consultation at outpatient departments and wards
  • Provide an uninterrupted supply of opioids
  • Incorporate palliative care services in undergraduate and postgraduate programmes
Clinicians undergo a 14-month course taught by a team of volunteer faculty. During this period, they will undergo:
  1. Foundation training
  2. Clinical attachment
  3. Visitor from mentor
  4. Refresher course
  5. External audit
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Bringing Relief to Asia Together

Lien Collaborative for Palliative Care (Lien Collab) draws on philanthropy, health institutions, palliative care service providers, individuals and more to strengthen leadership and capacity in bringing pain relief to all.

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