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Dimension	PakistanWorked example · 9 domains reviewed · 6 high-confidence · 3 dated estimates · 6 material gaps	IndiaAnalog · 9 domains reviewed · 7 high-confidence · 7 dated estimates · 8 material gaps	UgandaAnalog · 9 domains reviewed · 9 high-confidence · 6 dated estimates · 5 material gaps
Opioid supplyIs a therapeutic opioid physically available in the wards that need it?	3.71 MME per 1,000 people per day Opioid analgesic consumption, 2019 SOURCE-CHECKED · 2019 DATA³ 4.88 MME per 1,000 people per day Opioid analgesic consumption, 2015 SOURCE-CHECKED · 2015 DATA³	3.45 MME per 1,000 people per day Opioid analgesic consumption, 2019 SOURCE-CHECKED · 2019 DATA³ 1.39 MME per 1,000 people per day Opioid analgesic consumption, 2015 SOURCE-CHECKED · 2015 DATA³ 716 kg per year Medical morphine consumption, 1985 SOURCE-CHECKED¹⁵⁸ 18 kg per year Medical morphine consumption, 1997 SOURCE-CHECKED¹⁵⁸ 278 kg per year Medical morphine consumption, 2014 SOURCE-CHECKED · 2014 DATA¹⁵⁸ 0 percent Kerala government palliative care providers able to prescribe oral morphine, 2020 SOURCE-CHECKED · 2020 DATA¹²¹ No peer-reviewed before-and-after evaluation of the 2014 amendment's effect on consumption was found. Years after it, dispensing was still confined to hospital pharmacies in several states, and in Kerala no surveyed government provider could prescribe oral morphine.^3,11,119,121 Subnational evidence OpenDid national consumption rise because of the 2014 amendment, on an INCB-comparable series?	Government supplies free oral morphine as an essential medicine and has co-manufactured it nationally since 2011.¹² National evidence
Narcotics regulationWhat licensing regime governs stocking and dispensing, and when did it last change?	OpenWhich specific licensing clauses, in which provincial rules, produce the stocking bottleneck?	The 2014 NDPS amendment created an Essential Narcotic Drugs class regulated centrally and replaced multiple state licences with a single state-level Recognised Medical Institution approval from the State Drug Controller, under uniform central rules.^11,50 National evidence	Statutory Instrument 2004 No. 24, made under the National Drug Policy and Authority Statute, carries the prescriber expansion and ties prescribing to the Ministry of Health guidelines for handling Class A drugs.³⁴ National evidence
Prescriber authorityWho is legally allowed to prescribe, and can that group be widened?	Unknown people Practicing palliative specialists nationally, current ILLUSTRATIVE ONLY²⁵ OpenIs any nurse or clinical officer prescribing authority available under current law?	10 days Hands-on training required before a physician may prescribe oral morphine, Kerala, 2015 SOURCE-CHECKED · 2015 DATA⁵¹ The amendment created no new prescriber class. A registered medical practitioner still signs, but for essential narcotic drugs must additionally have completed training in pain relief and palliative care. Stocking and dispensing sit with the recognised medical institution, not the individual.^50,51 National evidence OpenHow many recognised medical institutions are registered nationally?	A clinical officer or nurse holding a certificate in specialist palliative care may prescribe and supply the listed morphine preparations, under the 2004 narcotic analgesic regulations.^12,34 National evidence
Service deliveryThrough what structure does care actually reach a patient at home?	Specialized palliative care in Pakistan is offered by only a few institutions. At Aga Khan University Hospital in Karachi, a program started in 2017 delivers inpatient, outpatient and home-based care and served 3747 patients in 2017 to 2019, and its outpatient clinic is described as the first in Karachi (self-reported, single institution).^278,279,280 Single-site evidenceSelf-reported OpenHow is palliative care delivered outside large private tertiary hospitals, for example in public hospitals and rural districts?	83 of 139 nationally Palliative care delivery points located in Kerala, 2008 SOURCE-CHECKED¹²⁴ 19 centres Palliative care centres in West Bengal's first phase of the national programme, 2018 SOURCE-CHECKED · 2018 DATA¹¹⁷ The National Programme for Palliative Care, launched in 2012, is implemented state by state and unevenly, with some states starting years later. Primary care wellness centres studied in Odisha offered inadequate palliative care. Services were heavily concentrated in Kerala.^124,117,122 Mixed scope OpenHow many services exist by state today, and how much post-2014 growth lies outside Kerala?	226 facilities Accredited palliative care facilities, 2020 SOURCE-CHECKED · 2020 DATA³⁵ 30 districts of 135 Districts with no accredited facility, 2020 SOURCE-CHECKED · 2020 DATA³⁵ 88.50 percent Population living in a district with a service, 2020 SOURCE-CHECKED · 2020 DATA³⁵ 68.10 percent Accredited facilities in the public sector, 2020 SOURCE-CHECKED · 2020 DATA³⁵ OpenWho staffs the accredited facilities, and how many carry a certificated prescriber?
FinancingWho pays for the drug, the visit and the workforce?	54.30 percent Out-of-pocket share of health spending, exact, 2020 UNDER REVIEW¹⁹	Palliative care associations report poor allocation and use of government funds and little insurance cover for home and outpatient palliative care. Patients at a national cancer centre called for palliative care to be added to the national insurance benefit packages.^118,120 Mixed scope OpenWho pays for morphine procurement at recognised medical institutions, and what does the national programme spend?	94 percent Stand-alone service donations from external sources, 2019 SOURCE-CHECKED · 2019 DATA³⁶ Government support to stand-alone services arrives as medicines, training and tax exemption rather than cash.³⁶ National evidence OpenWhat changed in donor funding after 2025?
Training and recognitionWhat credential exists, who awards it, and does anyone recognize it?	A postgraduate certificate in palliative care exists at National University of Medical Sciences with the Shaheen Palliative Care Project.⁷ Single-site evidence	24 percent Kerala palliative care providers with a full-time trained physician, 2020 SOURCE-CHECKED · 2020 DATA¹²¹ The national programme trains district medical officers through a short cascade model, and a 2024 assessment found most training need unmet afterwards. Even in Kerala, most providers had no full-time trained physician.^117,121 Mixed scope OpenWhen was the MD in Palliative Medicine recognised, and how many graduates and certificate holders are there?	12 months Diploma in Clinical Palliative Care, course length, 2022 SOURCE-CHECKED · 2022 DATA³⁷ The Diploma in Clinical Palliative Care is open to registered nurses and clinical officers, and its graduates may prescribe oral liquid morphine.³⁷ National evidence
Opioid safeguardsHow are misuse and diversion controlled, and are treatment and naloxone available, without blocking pain relief?	An anthropological study argues that narcotics enforcement aimed at illicit supply and unviably low price ceilings make morphine scarce in Pakistani hospitals while heroin circulates illicitly. In a national survey of 2,838 hospital health professionals, only 27.7% knew patients must sign an opioid agreement and 22.2% knew of the drug monitoring program. A mystery-shopper study found 95% of 200 sampled Punjab pharmacies were run by non-qualified staff and sold controlled drugs without prescription.^551,552,553 Mixed scope OpenIs opioid agonist treatment (methadone or buprenorphine) available in Pakistan outside pilot HIV programs, and is naloxone stocked in hospitals and pharmacies?	India's 1985 NDPS Act set harsh custodial sentences even for minor clerical errors in hospitals stocking opioids, and the 2014 amendment to improve medical access has been slow to implement. Opioid substitution therapy with buprenorphine, buprenorphine-naloxone and methadone grew through the National AIDS Control Programme, though coverage targets are still far off. Delhi doctors named tough opioid regulations as their most common barrier to prescribing, and people who use opioids in Kashmir reported low naloxone knowledge and poor access.^{540,541,542,543,544} Mixed scope OpenHow many Recognized Medical Institutions stock oral morphine under the 2014 NDPS amendment, state by state, and is take-home naloxone available outside deaddiction centers?	Uganda lets trained nurses prescribe oral morphine, and Hospice Africa Uganda assessed 34 patients on long-term oral morphine, finding two cases of addiction and one probable diversion among people with chronic non-cancer pain. Uganda introduced methadone treatment in 2020, with 55.2% of 343 clients retained at 12 months, and a Kampala pilot started 55 people on buprenorphine. Patients and supply staff still report legal barriers to an adequate opioid supply for pain.^{288,597,598,599,600} Mixed scopeSelf-reported OpenDoes Uganda run any prescription monitoring for oral morphine, and is naloxone available to palliative care teams or to people who use drugs?
Psychosocial and bereavementWhat psychological, social and grief support reaches patients and family caregivers?	At one Karachi hospital, 70.2% of 326 caregivers of oncology patients had anxiety and 38.0% had depression, and the authors call for routine psychological screening of caregivers. Family caregivers of women with advanced breast cancer in Punjab described financial strain and emotional stress, often using religion to cope.^554,555 Subnational evidence OpenWhich Pakistani palliative care services include psychologists, social workers or bereavement support for adult patients and families?	Cancer physicians who have worked with psycho-oncologists say the service improves care, and they call for national action to extend it equitably. In one Kerala district, 23.0% of 200 family caregivers of palliative patients had severe caregiver burden, and a home-based palliative unit that supported caregiver health and linked families to local government resources had a positive impact on caregiver burden. A national review found stigma toward the dying and the psychological burden of care add to limited, mostly urban end-of-life services.^{545,546,547,548} Mixed scope OpenHow many palliative care services in India employ a psychologist or medical social worker, and do any offer structured bereavement follow-up for adult patients' families?	Accredited palliative care facilities in Uganda offer psychosocial, legal, bereavement and spiritual support, but on average only for 7 months a year due to lack of transport and facilitation. A randomized trial in three public hospitals found that nurse-led palliative care with psychosocial support improved patient-reported outcomes for people with multidrug-resistant tuberculosis.^35,601 Mixed scope OpenHow many trained counselors, social workers or psychologists work in Uganda's palliative care services, and is caregiver mental health screened routinely?
Children's palliative careHow do children with life-limiting conditions get palliative care and the medicines they need?	A palliative team at a Peshawar cancer hospital reviewed notes for 150 referred children and found psychological and family challenges, financial constraints and limited resources. Bereaved parents at a Karachi hospital reported no institutional bereavement practices and barriers to psychological care, including stigma and cost. Caregivers of children with blood cancers receiving specialist palliative care in Karachi valued its holistic approach and better communication.^556,557,558 Single-site evidenceSelf-reported OpenHow many children in Pakistan are reached by pediatric palliative care each year, and are oral morphine formulations for children available at those centers?	Across three tertiary cancer centres, 2.7% of 150 children with cancer needed palliative care as the focus of treatment and 49.3% had moderate needs, yet clinicians judged only 7 of 150 likely to benefit from referral. Family caregivers had more psychological distress (57%) than the children (33%). A Tamil-language bereavement needs tool for parents of children who died of cancer (CANCOPE-PI) was co-developed with bereaved caregivers in south India.^549,550 Subnational evidence OpenHow many children receive pediatric palliative care in India each year, and are child-appropriate oral morphine formulations available at those services?	Uganda provides pediatric palliative care across the health system from neonates to young adults, yet in the Busoga sub-region 96.1% of children with cancer did not continue palliative care after discharge, and none of them had been referred to their nearest provider. Children were 6% of attendees at the Fort Portal hospital palliative care unit.^{287,602,603,288} Mixed scopeSelf-reported OpenHow many children receive palliative care in Uganda each year, and are child-appropriate morphine formulations stocked outside referral hospitals?
Hospice modelWhat does hospice mean here, who runs it, and in what settings?	Hospice care is not well established in Pakistan, and most end-of-life care happens in acute hospitals or at home. The hospice described in the literature is a charitable non-profit inpatient cancer hospice in Karachi, linked to a philanthropist-funded cancer hospital that also gives palliative care.^275,276 Single-site evidence OpenWhen was the Karachi hospice founded, and do any hospices or home hospice teams exist outside Karachi?	Indian palliative care grew out of an early hospice movement in the 1980s, and hospice is discussed as one setting within palliative care. A leading example is Karunashraya, a 73-bed nonprofit hospice in Bangalore that has given free inpatient and home care to advanced cancer patients for over 30 years.^281,283 Mixed scopeSelf-reported OpenHow many dedicated hospices exist in India, and how many are run by NGOs, faith groups or the state?	Hospice in Uganda means NGO-run services that mostly deliver home-based, outpatient and day care; Hospice Africa Uganda has operated since 1993. Kitovu Mobile Hospice offers mobile and home care and also cares for inpatients at Kitovu Hospital. Ugandan sources use hospice and stand-alone palliative care organization almost interchangeably.^284,285,36 Mixed scopeSelf-reported OpenHow many of Uganda's hospices run their own inpatient beds, and which are faith-based?
Hospice eligibilityWho can enter hospice, on what criteria, and how late do patients arrive?	The Karachi hospice admits patients with terminal cancer who are expected to die within six months, and it serves poor families. In a case study at the linked cancer and hospice hospital, all patients presented at a late stage of disease (single site).^275,276 Single-site evidence	At the Bangalore hospice, admissions were advanced cancer patients referred mainly by doctors, with word of mouth, friends and relatives of former patients also common routes. Median time from admission to death was 8 to 10 days in 2021 and 2022, which shows very late arrival (single site, pandemic period).²⁸¹ Single-site evidenceSelf-reported	Hospice Africa Uganda serves patients with AIDS as well as cancer, and people living with AIDS who were referred still presented with advanced disease after long suffering. Poverty and fear of stigma around disclosing an AIDS diagnosis acted as barriers to seeking help (single organization).^286,12 Single-site evidence OpenAre there written admission criteria or prognosis rules for Ugandan hospices, and at what stage do cancer patients arrive?
Hospice fundingWho pays for hospice care: a public benefit, insurance, charity or families?	The Karachi hospice is a charitable non-profit that gives food and medications to patients and their families during the stay. The linked cancer hospital is funded by philanthropists for people who cannot pay, while personal spending makes up around 58% of total health spending in Pakistan.^275,276 Single-site evidence	The Bangalore hospice provides care free of charge with support from the Indian Cancer Society and a Rotary club. A pediatric perspective reports limited government funding and little private philanthropy for hospice care, and names financial burden as one reason hospices are underused.^281,282 Mixed scopeSelf-reported	Stand-alone hospice and palliative care organizations in Uganda get 93% of their funding from donations, and 94% of those donations come from outside the country. Government support comes mainly as medicines, training and tax payments, and oral liquid morphine made at Hospice Africa Uganda is given free to prescribed patients.^36,12 National evidence OpenHas government budget support for hospices changed since public hospitals were told to provide palliative care?
Hospice reachHow many dying people use hospice, and who is left out?	At the time of one study, Karachi, a city of 16 million, had only one hospice. In a survey of 522 dialysis patients in seven units, only 5% reported knowledge of hospice services.^275,277 OpenHow many hospices exist in Pakistan today, and what share of people who die use them?	Dedicated pediatric hospices are limited because most hospices focus on adults, so many children receive end-of-life care in general hospitals or at home. At the Bangalore hospice, high-income patients were about 2% of admissions and women were the majority, and less than 2% of India's population is reported to have access to palliative care.^282,281 Mixed scopeSelf-reported OpenWhat share of deaths in India, by state and by diagnosis, occur with hospice involvement?	Only 11% of Ugandans who need palliative care receive it, with distance to hospitals and hospices and transport costs among the barriers. In Busoga sub-region, 96.1% of children with cancer did not continue palliative care after discharge, and none of them had been referred to a nearby provider. Rural, poor and pediatric populations are the groups most often left out.^284,287,288 Mixed scope OpenHow many patients do Ugandan hospices serve each year relative to national deaths?

Country comparison: Pakistan, India, Uganda

Dimensions shown on screen: Opioid supply, Narcotics regulation, Prescriber authority, Service delivery, Financing, Training and recognition, Opioid safeguards, Psychosocial and bereavement, Children's palliative care, Hospice model, Hospice eligibility, Hospice funding, Hospice reach. View: Evidence matrix. This printout carries every dimension regardless of the screen filter.

Pakistan (Worked example, Eastern Mediterranean)

Dimension	Register position	Grades and sources
Opioid supply	3.71 MME per 1,000 people per day Opioid analgesic consumption, 2019 4.88 MME per 1,000 people per day Opioid analgesic consumption, 2015	SOURCE-CHECKED · 2019 DATA SOURCE-CHECKED · 2015 DATA Sources 3
Narcotics regulation	Open question: Which specific licensing clauses, in which provincial rules, produce the stocking bottleneck?	Sources 21
Prescriber authority	Unknown people Practicing palliative specialists nationally, current Open question: Is any nurse or clinical officer prescribing authority available under current law?	ILLUSTRATIVE ONLY Sources 25
Service delivery	Specialized palliative care in Pakistan is offered by only a few institutions. At Aga Khan University Hospital in Karachi, a program started in 2017 delivers inpatient, outpatient and home-based care and served 3747 patients in 2017 to 2019, and its outpatient clinic is described as the first in Karachi (self-reported, single institution). Open question: How is palliative care delivered outside large private tertiary hospitals, for example in public hospitals and rural districts?	Sources 278, 279, 280
Financing	54.30 percent Out-of-pocket share of health spending, exact, 2020	UNDER REVIEW Sources 19, 29
Training and recognition	A postgraduate certificate in palliative care exists at National University of Medical Sciences with the Shaheen Palliative Care Project.	Sources 7
Opioid safeguards	An anthropological study argues that narcotics enforcement aimed at illicit supply and unviably low price ceilings make morphine scarce in Pakistani hospitals while heroin circulates illicitly. In a national survey of 2,838 hospital health professionals, only 27.7% knew patients must sign an opioid agreement and 22.2% knew of the drug monitoring program. A mystery-shopper study found 95% of 200 sampled Punjab pharmacies were run by non-qualified staff and sold controlled drugs without prescription. Open question: Is opioid agonist treatment (methadone or buprenorphine) available in Pakistan outside pilot HIV programs, and is naloxone stocked in hospitals and pharmacies?	Sources 551, 552, 553
Psychosocial and bereavement	At one Karachi hospital, 70.2% of 326 caregivers of oncology patients had anxiety and 38.0% had depression, and the authors call for routine psychological screening of caregivers. Family caregivers of women with advanced breast cancer in Punjab described financial strain and emotional stress, often using religion to cope. Open question: Which Pakistani palliative care services include psychologists, social workers or bereavement support for adult patients and families?	Sources 554, 555
Children's palliative care	A palliative team at a Peshawar cancer hospital reviewed notes for 150 referred children and found psychological and family challenges, financial constraints and limited resources. Bereaved parents at a Karachi hospital reported no institutional bereavement practices and barriers to psychological care, including stigma and cost. Caregivers of children with blood cancers receiving specialist palliative care in Karachi valued its holistic approach and better communication. Open question: How many children in Pakistan are reached by pediatric palliative care each year, and are oral morphine formulations for children available at those centers?	Sources 556, 557, 558
Hospice model	Hospice care is not well established in Pakistan, and most end-of-life care happens in acute hospitals or at home. The hospice described in the literature is a charitable non-profit inpatient cancer hospice in Karachi, linked to a philanthropist-funded cancer hospital that also gives palliative care. Open question: When was the Karachi hospice founded, and do any hospices or home hospice teams exist outside Karachi?	Sources 275, 276
Hospice eligibility	The Karachi hospice admits patients with terminal cancer who are expected to die within six months, and it serves poor families. In a case study at the linked cancer and hospice hospital, all patients presented at a late stage of disease (single site).	Sources 275, 276
Hospice funding	The Karachi hospice is a charitable non-profit that gives food and medications to patients and their families during the stay. The linked cancer hospital is funded by philanthropists for people who cannot pay, while personal spending makes up around 58% of total health spending in Pakistan.	Sources 275, 276
Hospice reach	At the time of one study, Karachi, a city of 16 million, had only one hospice. In a survey of 522 dialysis patients in seven units, only 5% reported knowledge of hospice services. Open question: How many hospices exist in Pakistan today, and what share of people who die use them?	Sources 275, 277

India (Analog, South-East Asia)

Dimension	Register position	Grades and sources
Opioid supply	3.45 MME per 1,000 people per day Opioid analgesic consumption, 2019 1.39 MME per 1,000 people per day Opioid analgesic consumption, 2015 716 kg per year Medical morphine consumption, 1985 18 kg per year Medical morphine consumption, 1997 278 kg per year Medical morphine consumption, 2014 0 percent Kerala government palliative care providers able to prescribe oral morphine, 2020 No peer-reviewed before-and-after evaluation of the 2014 amendment's effect on consumption was found. Years after it, dispensing was still confined to hospital pharmacies in several states, and in Kerala no surveyed government provider could prescribe oral morphine. Open question: Did national consumption rise because of the 2014 amendment, on an INCB-comparable series?	SOURCE-CHECKED · 2019 DATA SOURCE-CHECKED · 2015 DATA SOURCE-CHECKED SOURCE-CHECKED SOURCE-CHECKED · 2014 DATA SOURCE-CHECKED · 2020 DATA Sources 3, 11, 119, 121, 158
Narcotics regulation	The 2014 NDPS amendment created an Essential Narcotic Drugs class regulated centrally and replaced multiple state licences with a single state-level Recognised Medical Institution approval from the State Drug Controller, under uniform central rules.	Sources 11, 50
Prescriber authority	10 days Hands-on training required before a physician may prescribe oral morphine, Kerala, 2015 The amendment created no new prescriber class. A registered medical practitioner still signs, but for essential narcotic drugs must additionally have completed training in pain relief and palliative care. Stocking and dispensing sit with the recognised medical institution, not the individual. Open question: How many recognised medical institutions are registered nationally?	SOURCE-CHECKED · 2015 DATA Sources 50, 51
Service delivery	83 of 139 nationally Palliative care delivery points located in Kerala, 2008 19 centres Palliative care centres in West Bengal's first phase of the national programme, 2018 The National Programme for Palliative Care, launched in 2012, is implemented state by state and unevenly, with some states starting years later. Primary care wellness centres studied in Odisha offered inadequate palliative care. Services were heavily concentrated in Kerala. Open question: How many services exist by state today, and how much post-2014 growth lies outside Kerala?	SOURCE-CHECKED SOURCE-CHECKED · 2018 DATA Sources 124, 117, 122
Financing	Palliative care associations report poor allocation and use of government funds and little insurance cover for home and outpatient palliative care. Patients at a national cancer centre called for palliative care to be added to the national insurance benefit packages. Open question: Who pays for morphine procurement at recognised medical institutions, and what does the national programme spend?	Sources 118, 120
Training and recognition	24 percent Kerala palliative care providers with a full-time trained physician, 2020 The national programme trains district medical officers through a short cascade model, and a 2024 assessment found most training need unmet afterwards. Even in Kerala, most providers had no full-time trained physician. Open question: When was the MD in Palliative Medicine recognised, and how many graduates and certificate holders are there?	SOURCE-CHECKED · 2020 DATA Sources 117, 121
Opioid safeguards	India's 1985 NDPS Act set harsh custodial sentences even for minor clerical errors in hospitals stocking opioids, and the 2014 amendment to improve medical access has been slow to implement. Opioid substitution therapy with buprenorphine, buprenorphine-naloxone and methadone grew through the National AIDS Control Programme, though coverage targets are still far off. Delhi doctors named tough opioid regulations as their most common barrier to prescribing, and people who use opioids in Kashmir reported low naloxone knowledge and poor access. Open question: How many Recognized Medical Institutions stock oral morphine under the 2014 NDPS amendment, state by state, and is take-home naloxone available outside deaddiction centers?	Sources 540, 541, 542, 543, 544
Psychosocial and bereavement	Cancer physicians who have worked with psycho-oncologists say the service improves care, and they call for national action to extend it equitably. In one Kerala district, 23.0% of 200 family caregivers of palliative patients had severe caregiver burden, and a home-based palliative unit that supported caregiver health and linked families to local government resources had a positive impact on caregiver burden. A national review found stigma toward the dying and the psychological burden of care add to limited, mostly urban end-of-life services. Open question: How many palliative care services in India employ a psychologist or medical social worker, and do any offer structured bereavement follow-up for adult patients' families?	Sources 545, 546, 547, 548
Children's palliative care	Across three tertiary cancer centres, 2.7% of 150 children with cancer needed palliative care as the focus of treatment and 49.3% had moderate needs, yet clinicians judged only 7 of 150 likely to benefit from referral. Family caregivers had more psychological distress (57%) than the children (33%). A Tamil-language bereavement needs tool for parents of children who died of cancer (CANCOPE-PI) was co-developed with bereaved caregivers in south India. Open question: How many children receive pediatric palliative care in India each year, and are child-appropriate oral morphine formulations available at those services?	Sources 549, 550
Hospice model	Indian palliative care grew out of an early hospice movement in the 1980s, and hospice is discussed as one setting within palliative care. A leading example is Karunashraya, a 73-bed nonprofit hospice in Bangalore that has given free inpatient and home care to advanced cancer patients for over 30 years. Open question: How many dedicated hospices exist in India, and how many are run by NGOs, faith groups or the state?	Sources 281, 283
Hospice eligibility	At the Bangalore hospice, admissions were advanced cancer patients referred mainly by doctors, with word of mouth, friends and relatives of former patients also common routes. Median time from admission to death was 8 to 10 days in 2021 and 2022, which shows very late arrival (single site, pandemic period).	Sources 281
Hospice funding	The Bangalore hospice provides care free of charge with support from the Indian Cancer Society and a Rotary club. A pediatric perspective reports limited government funding and little private philanthropy for hospice care, and names financial burden as one reason hospices are underused.	Sources 281, 282
Hospice reach	Dedicated pediatric hospices are limited because most hospices focus on adults, so many children receive end-of-life care in general hospitals or at home. At the Bangalore hospice, high-income patients were about 2% of admissions and women were the majority, and less than 2% of India's population is reported to have access to palliative care. Open question: What share of deaths in India, by state and by diagnosis, occur with hospice involvement?	Sources 282, 281

Uganda (Analog, Africa)

Dimension	Register position	Grades and sources
Opioid supply	Government supplies free oral morphine as an essential medicine and has co-manufactured it nationally since 2011.	Sources 12
Narcotics regulation	Statutory Instrument 2004 No. 24, made under the National Drug Policy and Authority Statute, carries the prescriber expansion and ties prescribing to the Ministry of Health guidelines for handling Class A drugs.	Sources 34
Prescriber authority	A clinical officer or nurse holding a certificate in specialist palliative care may prescribe and supply the listed morphine preparations, under the 2004 narcotic analgesic regulations.	Sources 12, 34
Service delivery	226 facilities Accredited palliative care facilities, 2020 30 districts of 135 Districts with no accredited facility, 2020 88.50 percent Population living in a district with a service, 2020 68.10 percent Accredited facilities in the public sector, 2020 Open question: Who staffs the accredited facilities, and how many carry a certificated prescriber?	SOURCE-CHECKED · 2020 DATA SOURCE-CHECKED · 2020 DATA SOURCE-CHECKED · 2020 DATA SOURCE-CHECKED · 2020 DATA Sources 35
Financing	94 percent Stand-alone service donations from external sources, 2019 Government support to stand-alone services arrives as medicines, training and tax exemption rather than cash. Open question: What changed in donor funding after 2025?	SOURCE-CHECKED · 2019 DATA Sources 36
Training and recognition	12 months Diploma in Clinical Palliative Care, course length, 2022 The Diploma in Clinical Palliative Care is open to registered nurses and clinical officers, and its graduates may prescribe oral liquid morphine.	SOURCE-CHECKED · 2022 DATA Sources 37
Opioid safeguards	Uganda lets trained nurses prescribe oral morphine, and Hospice Africa Uganda assessed 34 patients on long-term oral morphine, finding two cases of addiction and one probable diversion among people with chronic non-cancer pain. Uganda introduced methadone treatment in 2020, with 55.2% of 343 clients retained at 12 months, and a Kampala pilot started 55 people on buprenorphine. Patients and supply staff still report legal barriers to an adequate opioid supply for pain. Open question: Does Uganda run any prescription monitoring for oral morphine, and is naloxone available to palliative care teams or to people who use drugs?	Sources 288, 597, 598, 599, 600
Psychosocial and bereavement	Accredited palliative care facilities in Uganda offer psychosocial, legal, bereavement and spiritual support, but on average only for 7 months a year due to lack of transport and facilitation. A randomized trial in three public hospitals found that nurse-led palliative care with psychosocial support improved patient-reported outcomes for people with multidrug-resistant tuberculosis. Open question: How many trained counselors, social workers or psychologists work in Uganda's palliative care services, and is caregiver mental health screened routinely?	Sources 35, 601
Children's palliative care	Uganda provides pediatric palliative care across the health system from neonates to young adults, yet in the Busoga sub-region 96.1% of children with cancer did not continue palliative care after discharge, and none of them had been referred to their nearest provider. Children were 6% of attendees at the Fort Portal hospital palliative care unit. Open question: How many children receive palliative care in Uganda each year, and are child-appropriate morphine formulations stocked outside referral hospitals?	Sources 287, 602, 603, 288
Hospice model	Hospice in Uganda means NGO-run services that mostly deliver home-based, outpatient and day care; Hospice Africa Uganda has operated since 1993. Kitovu Mobile Hospice offers mobile and home care and also cares for inpatients at Kitovu Hospital. Ugandan sources use hospice and stand-alone palliative care organization almost interchangeably. Open question: How many of Uganda's hospices run their own inpatient beds, and which are faith-based?	Sources 284, 285, 36
Hospice eligibility	Hospice Africa Uganda serves patients with AIDS as well as cancer, and people living with AIDS who were referred still presented with advanced disease after long suffering. Poverty and fear of stigma around disclosing an AIDS diagnosis acted as barriers to seeking help (single organization). Open question: Are there written admission criteria or prognosis rules for Ugandan hospices, and at what stage do cancer patients arrive?	Sources 286, 12
Hospice funding	Stand-alone hospice and palliative care organizations in Uganda get 93% of their funding from donations, and 94% of those donations come from outside the country. Government support comes mainly as medicines, training and tax payments, and oral liquid morphine made at Hospice Africa Uganda is given free to prescribed patients. Open question: Has government budget support for hospices changed since public hospitals were told to provide palliative care?	Sources 36, 12
Hospice reach	Only 11% of Ugandans who need palliative care receive it, with distance to hospitals and hospices and transport costs among the barriers. In Busoga sub-region, 96.1% of children with cancer did not continue palliative care after discharge, and none of them had been referred to a nearby provider. Rural, poor and pediatric populations are the groups most often left out. Open question: How many patients do Ugandan hospices serve each year relative to national deaths?	Sources 284, 287, 288

Sources cited in this comparison

3. Ju C, Wei L, Man KKC, et al. Global, regional and national trends in opioid analgesic consumption, 2015 to 2019. Lancet Public Health 2022;7:e335-46. DOI 10.1016/S2468-2667(22)00013-5.
7. National University of Medical Sciences. Postgraduate Certificate in Palliative Care, with the Shaheen Palliative Care Project. Admissions materials and national press coverage, 2021 and 2025.
11. Pallium India, Guidelines for stocking and dispensing Essential Narcotic Drugs, with International Drug Policy Consortium analysis of the 2014 NDPS amendment.
12. Merriman A, Mwebesa E, Zirimenya L. Improving access to palliative care for patients with cancer in Africa: 25 years of Hospice Africa. Ecancermedicalscience 2019;13:946. DOI 10.3332/ecancer.2019.946. Nurse and clinical officer prescribing authority; free government oral morphine; local manufacture from 2011.
19. WHO Global Health Expenditure Database. Out-of-pocket spending 54.3 percent of current health expenditure, 2020.
21. Business Recorder, 2025, on hardship-category drug shortages including oral morphine for palliative care, and delayed approval of recommended price revisions.
25. Letter: palliative care needs assessment for Pakistan. Journal of Palliative Medicine, 2022. PMC9248331. Cites nine palliative and pain fellowship programs on CPSP listings.
29. Commonwealth Fund, International Health Policy Center, Pakistan country profile. Sehat Sahulat coverage near PKR 460,000 per family; approximately 44.6 million households by 2022.
34. Republic of Uganda, Statutory Instruments 2004 No. 24. National Drug Authority (Prescription and Supply of Certain Narcotic Analgesic Drugs) Regulations, made under the National Drug Policy and Authority Statute 1993. Rule 4 authorises a clinical officer or nurse holding a certificate in specialist palliative care to prescribe and supply listed morphine preparations. Full text hosted by the Palliative Care Association of Uganda.
35. Kagarmanova A, Mwesiga MD, Sisk ML, et al. Palliative care in Uganda: quantitative descriptive study of key palliative care indicators 2018 to 2020. BMC Palliative Care 2022;21:55. DOI 10.1186/s12904-022-00930-7. Accredited facility and district counts, population coverage against the 2014 census, and the public-sector share of facilities.
36. Amandua J, Kimaro MS, Mwebesa E, Taremwa IM, Atuhairwe C. The financing of stand-alone palliative care services in Uganda: analysis of the implications for sustainability. BMC Palliative Care 2019;18(1):48. DOI 10.1186/s12904-019-0434-5. External share of donations, income-generating share, and the government contribution in medicines, training and tax exemption rather than cash.
37. Institute of Hospice and Palliative Care in Africa, Hospice Africa Uganda. Diploma in Clinical Palliative Care: a twelve month programme open to registered nurses and clinical officers, whose graduates may prescribe oral liquid morphine under Statutory Instrument 2004 No. 24. Programme materials and partner reporting, with the first advanced diploma nursing cohort graduating in 2022.
50. Narcotic Drugs and Psychotropic Substances (Third Amendment) Rules, 2015. G.S.R. 359(E), Ministry of Finance, Department of Revenue, Gazette of India, 5 May 2015, made under the 2014 amendment. Defines a registered medical practitioner for essential narcotic drugs as a practitioner registered under existing medical or dental registration law who has additionally completed training in pain relief and palliative care, or in opioid substitution therapy. Rules 52A and 52F place possession, dispensing and sale with the recognised medical institution.
51. Oral morphine use in South India: a population-based study. PMC5735973. Describes the rules in operation: morphine is dispensed by an approved provider affiliated with a recognised medical institution, physicians may prescribe oral morphine only after completing ten days of hands-on training in pain relief and palliative care, and each institution reports annual consumption to the Office of the Drugs Controller.
117. Mitra S, Sarkar AK. Assessment of training need for National Program for Palliative Care and digital legacy planning among medical officers of an eastern state of India. Indian Journal of Palliative Care 2026;32(1):60-64. DOI 10.25259/IJPC_86_2025. The national programme launched in 2012 and trains district medical officers through a cascade model; West Bengal began phased rollout only in 2017 to 2018; substantial unmet training need after a training day. Full text read.
118. Atreya S, Butola S, Bhatnagar S, Kumar D, Muckaden M, Kuraikose J, et al. Integration of palliative care into primary care: a collaborative effort between the Indian Association of Palliative Care and the Indian Association of Preventive and Social Medicine. Indian Journal of Community Medicine 2024;49(Suppl 2):S234-S239. DOI 10.4103/ijcm.ijcm_858_24. Position paper: poor allocation and use of government funds for palliative care, and little insurance cover for home and outpatient palliative care. Full text read.
119. Bouothmani A, Gutierrez R, Lamrous A, Burza S, Maixenchs M, Richardson K. Access to opioids for palliative care in humanitarian settings: two case studies of Medecins Sans Frontieres experience in India and Bangladesh. BMC Palliative Care 2025;24(1):90. DOI 10.1186/s12904-025-01673-x. Interviews on a project in Patna, Bihar, 2020 to 2022: limited availability, burdensome regulatory processes, dispensing confined to hospital pharmacies in several states, and lack of prescriber training. Full text read.
120. Gore S, Mhamane S, Jadhav S, Padvi N, Mhatre A, Joshi P, et al. Implementation challenges of government-funded health schemes for cancer treatment at Tata Memorial Centre. Journal of Cancer Policy 2025;43:100564. DOI 10.1016/j.jcpo.2025.100564. Abstract read. Low beneficiary awareness of the national insurance scheme and a call to add supportive and palliative care to benefit packages.
121. Lijimol AS, Krishnan A, Rajagopal MR, Gopal BK, Booth CM. Improving access and quality of palliative care in Kerala: a cross-sectional study of providers in routine practice. Indian Journal of Palliative Care 2020;26(4):500-505. DOI 10.4103/IJPC.IJPC_17_20. Telephone survey of government and non-government palliative care providers in Kerala: trained physicians, pain documentation, and ability to prescribe oral morphine. Abstract read.
122. Panda SK, Panda D, Behera RR, Panda SC, Munda A, Sahu PR. Assessment of functioning of health and wellness centers of Western Odisha: a cross-sectional study. Cureus 2023;15(4):e37665. DOI 10.7759/cureus.37665. Palliative care services inadequate at the primary care centres studied. Full text read.
124. Banerjee D. Culture, communication and community in palliative cancer care: a view from India. ecancermedicalscience 2022;16:ed120. DOI 10.3332/ecancer.2022.ed120. Kerala's network built on the 1996 decentralisation reforms, and a 2008 count of palliative care delivery points nationally, most of them in Kerala. Full text read.
158. Jacob A, Mathew A. End-of-life care and opioid use in India: challenges and opportunities. Journal of Global Oncology 2017;3(6):683-686. DOI 10.1200/JGO.2016.008490. States that morphine use fell from 716 kg in 1985 to 18 kg by 1997 (INCB consumption data compiled by the Pain and Policy Studies Group) and that total consumption was 278 kg in 2014; after the 2014 amendment a single licence suffices to procure and dispense morphine. Full text read.
275. Lalani NS, Duggleby W, Olson J "I Need Presence and a Listening Ear": Perspectives of Spirituality and Spiritual Care Among Healthcare Providers in a Hospice Setting in Pakistan. J Relig Health 2021;60(4):2862-2877. Qualitative interview study of hospice staff whose study-context section describes the only hospice in Karachi (45-bed, charitable, cancer-only, six-month prognosis rule, free food and medicines); single site. Full text read.
276. Rattani SA, Dahlke S, Cameron B Cancer Care in Pakistan: A Descriptive Case Study. Glob Qual Nurs Res 2022;9:23333936221080988. Qualitative case study (12 participants) at a philanthropist-funded cancer and hospice hospital in Karachi describing late presentation, poverty and lack of morphine; single site. Full text read.
277. Saeed F, Sardar M, Rasheed K, et al. Dialysis Decision Making and Preferences for End-of-Life Care: Perspectives of Pakistani Patients Receiving Maintenance Dialysis. J Pain Symptom Manage 2020;60(2):336-345. Survey of 522 patients in seven dialysis units showing very low awareness of hospice and palliative care; convenience sample. Abstract read.
278. Jabeen I, Qureshi A, Waqar MA Development of Palliative Care Services at a Tertiary Care Teaching Hospital in Pakistan: Retrospective Analysis of Existing Palliative Care Program. J Pain Symptom Manage 2022;64(2):178-185. Retrospective review of the Aga Khan University Hospital palliative care program 2017-2019 with inpatient, outpatient and home care; self-evaluation by program staff, single institution; a corrigendum was published (PMID 38219084). Abstract read.
279. Rafaqat W, Syed AR, Ahmed IM, et al. Impact of an outpatient palliative care consultation and symptom clusters in terminal patients at a tertiary care center in Pakistan. BMC Palliat Care 2023;22(1):75. Before-after symptom study of 78 outpatients at the first outpatient palliative care center in Karachi; single institution, includes program staff as authors. Abstract read.
280. Saeed S, Tousif K, Fatir CA, et al. Impact of COVID-19 on palliative care of cancer patients: Perspectives from Pakistan. Ann Med Surg (Lond) 2022;78:103705. Short commentary stating that only a few institutions provide specialized palliative care in Pakistan; opinion piece, not primary data. Abstract read.
281. Reddy M, Rao S, N S Hospice referral patterns in India during COVID-19: A retrospective study on advanced cancer patients. BMC Palliat Care 2026;25(1). Retrospective review of 740 admissions to Karunashraya, a 73-bed free nonprofit hospice in Bangalore, showing median admission-to-death of 8 to 10 days; single site, pandemic period, author affiliated with the hospice (self-evaluation). Full text read.
282. Nair M, Ghoshal A Hospice Care in India-A Pediatrician's Perspective. South Asian J Cancer 2023;12(3):303-308. Perspective article on pediatric hospice care in India covering scarce child-specific hospices, funding gaps and underuse; opinion and advocacy, not primary data. Full text read.
283. Salins N, Bhatnagar S, Simha S, et al. Palliative Care in India: Past, Present, and Future. Indian J Surg Oncol 2022;13(Suppl 1):83-90. Narrative history tracing Indian palliative care from the 1980s hospice movement to specialist practice; written by leaders of Indian palliative care organizations (including Karunashraya and Pallium India), so an insider and advocacy view. Abstract read.
284. Mah K, Namisango E, Luyirika E, et al. Quality of Dying and Death of Patients With Cancer in Hospice Care in Uganda. JCO Glob Oncol 2023;9:e2200386. Bereaved-caregiver survey (N=202) at two Ugandan hospices (Kitovu Mobile Hospice and Hospice Africa Uganda) that describes both services and reports poor symptom control near death; two-site scope, co-authors include African Palliative Care Association staff. Full text read.
285. Campbell J, Buyinza N, Hauser J Perspective on Care at the End of Life at Hospice Africa Uganda. J Palliat Med 2018;21(7):901-906. Survey of 46 patients, 51 caregivers and 25 providers at Hospice Africa Uganda (Kampala and satellites) on end-of-life priorities; single organization, one co-author is HAU staff. Abstract read.
286. Too W, Watson M, Harding R, et al. Living with AIDS in Uganda: a qualitative study of patients' and families' experiences following referral to hospice. BMC Palliat Care 2015;14:67. Qualitative interviews with 22 AIDS patients and 20 caregivers newly referred to Hospice Africa Uganda; single organization. Abstract read.
287. Ajambo M, Mwaka S, Nyanzi JG, et al. Paediatric palliative care following hospital discharge: Prevalence and factors associated with non-continuity of palliative care for children with cancer in Busoga sub-region-eastern Uganda; A mixed methods study. PLOS Glob Public Health 2026;6(1):e0004210. Mixed-methods study at two tertiary facilities and one hospice centre finding 96.1% non-continuity of pediatric palliative care; one sub-region, first author affiliated with Ministry of Health. Abstract read.
288. Downing J, Ndagire M, Irumba LC Striving for Equity, Justice, and Access to Palliative Care Through Cancer and Palliative Nursing in Uganda: A Narrative Review. Semin Oncol Nurs 2026;42(3):152249. Narrative review supported by authors' expert knowledge on nursing and equity in Ugandan palliative care; authors are sector advocates. Abstract read.
540. Vallath N, Rajagopal MR, Perera S, et al. Access to pain relief and essential opioids in the WHO South-East Asia Region: challenges in implementing drug reforms. WHO South East Asia J Public Health 2018;7(2):67-72. Regional review of opioid access in the WHO South-East Asia Region, covering India's NDPS Act and its 2014 amendment and noting progress in Bangladesh, India, Nepal and Sri Lanka; authors include palliative care advocates. Abstract read.
541. Rajagopal MR Access to palliative care: insights into ground realities post-2014 amendment to NDPS Act. Indian J Med Ethics 2016;1(1):25-30. Commentary on palliative care access in India after the 2014 NDPS amendment; author is a leading palliative care advocate. Abstract read.
542. Rao R The journey of opioid substitution therapy in India: Achievements and challenges. Indian J Psychiatry 2017;59(1):39-45. Narrative review of three decades of opioid substitution therapy in India, including its place in the National AIDS Control Programme. Abstract read.
543. Singh S, Prasad S, Bhatnagar S, et al. A Cross-Sectional Web-Based Survey of Medical Practitioners in India to Assess their Knowledge, Attitude, Prescription Practices, and Barriers toward Opioid Analgesic Prescriptions. Indian J Palliat Care 2019;25(4):567-574. Web survey of 308 doctors at three tertiary hospitals in New Delhi on opioid prescribing barriers; low response rate (10.4%). Abstract read.
544. Raj R, Parveen S, Wani SM, et al. Perspectives of opioid users on overdose recognition, naloxone administration, and attitudes. Ind Psychiatry J 2026;35(1):99-104. Cross-sectional study of 501 people with opioid use disorder at one deaddiction center in Srinagar on overdose and naloxone knowledge; single site. Abstract read.
545. Mathew B, Lam WWT, Tiwari S, et al. Expanding Psycho-Oncology Services in India: Perspectives From Physicians in Cancer Care Centres. Psychooncology 2025;34(9):e70271. Qualitative interviews with 20 cancer physicians in India on integrating psycho-oncology services. Abstract read.
546. Parvathi R, Gopika GB, Basheer MTB, et al. The double burden of stress and caregiving among family caregivers of palliative care patients: Findings from a cross-sectional study in Kerala, India. Arch Psychiatr Nurs 2026;61:152102. Cross-sectional study of caregiver burden among 200 informal caregivers of palliative care patients in one Kerala district. Abstract read.
547. Nair MS, Augustine A, Nair G Impact of Interventions From a Secondary Home-Based Palliative Care Unit on Caregiver Burden in Kerala, India. Cureus 2025;17(4):e82481. Mixed-methods evaluation of one secondary home-based palliative care unit in Kerala described by authors as best performing; single unit, small sample (36 caregivers). Abstract read.
548. Varkey BPA, Ghoshal A, Salins N, et al. Mapping end-of-life care in India: a scoping review to identify gaps in policy, practice, and psychosocial support. BMC Palliat Care 2025;24(1):189. Scoping review of end-of-life care in India from 1990 to 2024 covering policy, practice and psychosocial support. Abstract read.
549. Verma V, Rao KS, Ghoshal A, et al. Assessing the palliative care needs of children with cancer and their families in tertiary care centres in India: A multicentre observational study. Palliat Care Soc Pract 2026;20:26323524261430380. Multicentre cross-sectional study of palliative care needs of 150 children with cancer at three Indian tertiary cancer centres using the PaPaS scale. Abstract read.
550. Suresh V, Mittal A, Venketeswaran MV, et al. Developing a culturally relevant bereavement needs assessment tool (CANCOPE-PI) for caregivers of children with cancer in India: a participatory research approach. Res Involv Engagem 2026;12(1). Participatory development of a bereavement needs assessment tool for caregivers of children who died of cancer at one south Indian cancer center. Abstract read.
551. Hayat Z Regimes of pain: The geopolitics of cancer palliation in Pakistan. Med Anthropol Q 2024;38(3):271-284. Anthropological analysis of how narcotics control and price control shape morphine scarcity for cancer pain in Pakistan; interpretive, not a measurement study. Abstract read.
552. Arshad H, Gillani AH, Rehman JU, et al. Awareness about opioids crisis, policies and regulation of opioid stewardship at hospitals settings: a nationwide cross-sectional study among healthcare professionals from Pakistan. Subst Abuse Treat Prev Policy 2026;21(1). Nationwide survey of 2,838 health professionals in 59 Pakistani hospitals on opioid stewardship awareness and practice. Abstract read.
553. Bashir I, Ahmad M, Jamshaid M, et al. Illicit sale of controlled drugs at community pharmacy/medical stores of Punjab, Pakistan: A road to demolition of public health. Heliyon 2021;7(5):e07031. Mystery-shopper study of 200 community pharmacies in Punjab, Pakistan, on sale of controlled drugs without prescription. Abstract read.
554. Kamal M, Khan A, Athar S, et al. Prevalence of Anxiety and Depression among Primary Caregivers of Oncologic Patients: A Cross-Sectional Study from a Tertiary Care Hospital of Karachi, Pakistan. Semin Oncol Nurs 2026;42(4):152295. Cross-sectional study of anxiety and depression among 326 caregivers of oncology patients at one Karachi hospital. Abstract read.
555. Jabeen S, Zakar R, Zakar MZ, et al. Experiences of family caregivers in dealing with cases of advanced breast cancer: a qualitative study of the sociocultural context in Punjab, Pakistan. BMC Public Health 2024;24(1):1030. Qualitative study of 15 family caregivers of women with advanced breast cancer in Punjab, Pakistan. Abstract read.
556. Khurshid S, Saleem A, Khanzada ZS Barriers to Palliative Care for Terminally Ill Children in a Developing Country Cancer Hospital: A Qualitative Study. J Cancer Allied Spec 2026;12(1):24-29. Retrospective qualitative analysis of palliative team notes for 150 children at Shaukat Khanum Memorial Cancer Hospital, Peshawar; single site, authors are the service's own staff. Abstract read.
557. Hussain H, Altaf S, Khalid A, et al. Exploring challenges and opportunities in paediatric bereavement care: a qualitative study from a tertiary care hospital in Pakistan. BMC Palliat Care 2026;25(1). Qualitative study of 19 bereaved parents at Aga Khan University Hospital, Karachi, on bereavement care gaps; single site. Abstract read.
558. Shariq S, Sultan A, Bukhari SI, et al. Navigating the landscape of paediatric haematological malignancies: a qualitative exploration of caregivers' experiences and palliative care integration in Pakistan. BMC Palliat Care 2026;25(1). Qualitative study of 13 caregivers of children with blood cancers receiving integrated palliative care at a private Karachi hospital; single site. Abstract read.
597. Duncan B, Natuhwera G, Nassuuna D, et al. Serious Adverse Drug Reactions to Long-Term Oral Liquid Morphine in Patients with Chronic Pain: A Cross-Sectional Survey in Palliative Care. J Pain Res 2025;18:2361-2371. Survey at Hospice Africa Uganda of patients on long-term oral liquid morphine assessed for serious adverse reactions, including addiction and diversion; single hospice reviewing its own patients (self-evaluation). Abstract read.
598. Mudiope P, Mutamba BB, Komuhangi L, et al. Retention of people who inject drugs enrolled in a 'medications for opioid use disorder' (MOUD) programme in Uganda. Addict Sci Clin Pract 2024;19(1):39. Retrospective cohort of 343 people who inject drugs started on methadone in Uganda's program in Kampala, 2020 to 2022, reporting 12-month retention; single clinic. Abstract read.
599. Dickson-Gomez J, Tarima S, Twaibu W, et al. Feasibility, Acceptability, and Preliminary Efficacy of a Pilot Study To Integrate Buprenorphine into a Harm-reduction Drop-in-Center in Kampala, Uganda. AIDS Behav 2025;30(5):1338-1351. Pilot study integrating buprenorphine into a harm-reduction drop-in center in Kampala; 62 people screened; small uncontrolled pilot. Abstract read.
600. Weiss Goitiandia S, Namisango E, Luyirika EBK, et al. The legal needs of people receiving palliative care in Uganda: A multi-method assessment to advance universal health coverage. Palliat Care Soc Pract 2025;19:26323524251347652. Multi-method assessment of legal needs among 384 people receiving palliative care at three Ugandan sites, with key informant interviews including medicines supply staff. Abstract read.
601. Buyinza N, Nkhoma K, Namisango E, et al. Nurse-led palliative care for multidrug-resistant tuberculosis: a parallel, single-blind, pragmatic, randomised controlled trial in Uganda. Lancet Glob Health 2025;13(8):e1448-e1457. Pragmatic randomized trial of nurse-led palliative care, including psychosocial support, for 154 adults with multidrug-resistant tuberculosis in three Ugandan public hospitals; funded by Open Society Foundations. Abstract read.
602. Batanda I, Birungi D A descriptive analysis of hospital-based palliative care services: a case study from Fort Portal Regional Referral Hospital, Uganda. BMC Health Serv Res 2026. Descriptive case study of 2,133 attendances at the palliative care unit of Fort Portal Regional Referral Hospital, July 2019 to May 2026; single site. Abstract read.
603. Downing J, Namukwaya E, Nakawesi J, et al. Shared-decision-making and communication in paediatric palliative care within Uganda. Curr Probl Pediatr Adolesc Health Care 2024;54(1):101556. Review of shared decision-making and communication in pediatric palliative care in Uganda; authors from national palliative care organizations (self-evaluation). Abstract read.