Postpartum Depression Screening at Well-Child Visits: Validity of a 2-Question Screen and the PHQ-9

TLDR

Palliative care is a core component of Universal Health Coverage and is increasingly vital in low‑ and middle‑income countries where non‑communicable diseases are rising. The study aims to examine how palliative care can address the growing burden of serious health‑related suffering and enhance primary‑care‑based NCD management in LMICs. Using a border‑region project in India and Nepal, the authors describe an integrated model that embeds palliative care throughout the NCD care continuum. The authors propose that this integrated model could serve as a framework for NCD management in rural India, Nepal, and other LMICs pursuing UHC.

Abstract

Palliative care is recognised as a fundamental component of Universal Health Coverage (UHC), which individual countries, led by the United Nations and the WHO, are committed to achieving worldwide by 2030—Sustainable Development Goal (SDG) 3.8. As the incidence of non-communicable diseases (NCD) in low-income and middle-income countries (LMICs) increases, their prevention and control are the central aspects of UHC in these areas. While the main focus is on reducing premature mortality from NCDs (SDG 3.4), palliative care is becoming increasingly important in LMICs, in which 80% of the need is found. This paper discusses the challenges of providing comprehensive NCD management in LMICs, the role of palliative care in addressing the huge and growing burden of serious health-related suffering, and also its scope for leveraging various aspects of primary care NCD management. Drawing on experiences in India and Nepal, and particularly a project on the India– Nepal border in which palliative care, community health and primary care-led NCD management are being integrated, we explore the synergies arising and describe a model where palliative care is integral to the whole spectrum of NCD management, from promotion and prevention, through treatment, rehabilitation and palliation. We believe this model could provide a framework for integrated NCD management more generally in rural India and Nepal and also other LMICs as they work to make NCD management as part of UHC a reality.