Strategies to enhance palliative care access in rural populations and increase awareness of life-limiting illnesses in India: A scoping review

Background

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.

Objectives

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.

Methods

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.

Results

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.

Conclusions

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.