How palliative care reaches patients, by country

Only a small minority of patients in need reach palliative services. Province-level indicators show unequal development, with the north-west in greatest need, and pediatric palliative care is not yet fully integrated.^239,240,241

OpenIs there a national palliative care law or program, and how is it implemented across provinces?

• 0 teams Hospital palliative support teams, Armenia, 2019¹⁵⁷
• 1 provider Palliative service providers still operating after the Global Fund pilots, Armenia, 2017¹⁵⁵

Hospital support teams and inpatient services largely disappeared between 2005 and 2012, and of the four donor-funded pilot programmes only one provider remained.^157,155

OpenHow many services operate today, and what did the 2017 to 2021 scale-up add?

Care is delivered in hospital, home, outpatient, aged care, correctional and disability settings. A government-funded national outcomes and benchmarking program has run since 2005, voluntary for services, and a parallel program for aged care homes began in 2021 with partial uptake. Its evaluators found benchmarking improves care only with education and implementation support.^165,166

OpenDo participating services achieve better patient outcomes than non-participating ones?

• 18 people Community members completing the volunteer training course, Bangladesh, 2018⁴³

The Centre for Palliative Care at Bangabandhu Sheikh Mujib Medical University runs the Compassionate Korail community programme with the Worldwide Hospice Palliative Care Alliance, begun in 2015 and extended to Narayanganj.^42,43

OpenHow many community palliative assistants are working nationally, and under whose supervision?

Most people depend only on the public system, yet about half of palliative services are public and many sit in the Southeast. A first health resolution on palliative care came in 2018, and a 2020 to 2024 national program built primary palliative care in linked hospital, outpatient and home clusters.^235,236,234

OpenWhat national instrument followed the 2018 resolution, and how far is it implemented?

In Ontario, physician palliative care is split among generalist, consultation and specialist models with similar outcomes, and home visits may promote community death. Many decedents received no home visit from a physician or nurse practitioner in their last months.^218,217

OpenDo Ontario's patterns hold in other provinces and in Indigenous and rural communities?

• 93 percent Cancer patients in need who had access to palliative care, Chile, 2019¹⁰⁶
• 58 percent People in need of palliative care without access, Chile, 2019¹⁰⁶
• 42,214 patients Publicly insured patients with palliative care access, Chile, 2019¹⁰⁶

The guarantee reached nearly all cancer patients in need, but coverage stopped at cancer, so most of the national gap lies in non-cancer illness. The 2021 law is meant to close it.¹⁰⁶

OpenHow many palliative teams operate, and how are they distributed by region?

The first national hospice programme and service guidelines came in 2017, followed by three batches of national pilots. National policy sets a hospital, community and home model and leaves implementation to local governments, and provider practice varies widely by region.^182,183,181

OpenHow many pilot cities run working home and community hospice services?

• 63 services Registered palliative and pain services, Colombia, 2010⁸⁴
• 102 services Registered palliative and pain services, Colombia, 2014⁸⁴
• 454 services Registered palliative and pain services, Colombia, 2019⁸⁴
• 6 departments Departments with no registered palliative service, Colombia, 2019⁸⁴

Registered services grew several-fold after the law, concentrated in Bogota and the larger cities. Several departments still had no registered service despite the law's national scope.⁸⁴

OpenWhat is the service count after 2020, by department?

• 8.10 index score, highest in the region Latin American palliative care development index, Costa Rica, 2012¹⁴²
• 14.65 per million Palliative care services per million inhabitants, Costa Rica, 2012¹⁴²

In the early 2010s Costa Rica led Latin America on the composite development index and ranked second on service density, anchored by a national pain and palliative care centre.¹⁴²

OpenHow many teams operate today, and how are they spread across the social security regions?

• 4 centres Recognised palliative care centres, Egypt, 2024⁹¹

Dedicated palliative care is concentrated in Cairo, while general oncology reaches every public university and ministry centres in the provinces. Oncology reach has not carried palliative care with it.^91,92

OpenDo the Assiut or Alexandria cancer centres run a recognised palliative or home care service?

• 50 percent National target for public health facilities offering palliative care by 2020, Ethiopia, 2020¹³⁶
• 24 centres Oncology centres, expanded from one, Ethiopia, 2023¹³⁴

Services remain concentrated in Addis Ababa, with NGO hospice provision, while cancer treatment expanded to many oncology centres. The national target for palliative care in public facilities was set without the drug supply to support it.^136,134

OpenHow many palliative services operate, and in which regions?

• 16.70 percent Estimated palliative care need met through the formal health system, Georgia, 2024¹⁵⁴
• 74.60 percent Inpatient palliative beds located in Tbilisi, Georgia, 2024¹⁵⁴

Care runs through inpatient facilities, a handful of outpatient units and primary care home visits. Most beds are in Tbilisi, most regions have no outpatient service, and home care fell for lack of funding.¹⁵⁴

OpenWhat would it take to restore home care in the regions?

Specialist palliative home care became an insured entitlement in 2007, delivered by physician and nurse teams with a 24/7 call service; generalist outpatient palliative care, mainly by general practitioners, followed in 2013. After the 2015 Hospice and Palliative Care Act, outpatient palliative care did not increase in one state's claims data.^174,175

OpenWhy did generalist outpatient palliative care decline while specialist care grew after 2015?

• 83 of 139 nationally Palliative care delivery points located in Kerala, India, 2008¹²⁴
• 19 centres Palliative care centres in West Bengal's first phase of the national programme, India, 2018¹¹⁷

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

OpenHow many services exist by state today, and how much post-2014 growth lies outside Kerala?

• 333 centres Jakarta primary health centres trained in palliative care, Indonesia, 2020⁷¹
• 713 patients Cancer patients given palliative care in the Jakarta programme, Indonesia, 2020⁷¹
• 114 branches Indonesian Cancer Foundation branches, Indonesia, 2023⁷¹

Services cluster in a few cities, with Surabaya's city team dating from 1992 and a Jakarta programme run through primary health centres with the Indonesian Cancer Foundation. Reporting comes mainly from Java and Sumatra, and the 2026 policy brief proposes a tiered national model.^69,71

OpenHow many palliative teams operate outside Java and Sumatra?

The regional survey places Iran in the lower development cluster with Morocco, Iraq, Egypt and Pakistan, while naming it among countries with an early increase in specialised services.⁴⁹

OpenHow many specialised services exist, and where? NGO and cancer institute services were named in the brief but not documented.

• 19 days Mean wait from referral to palliative radiotherapy, Sulaimani, Iraq, 2015¹²⁹

The regional survey places Iraq in the lower development cluster with Iran, Morocco, Egypt and Pakistan, and among the territories facing added suffering from conflict. At one Kurdistan cancer centre, patients living far from it refused treatment.^49,129

OpenHow many palliative services exist, and where?

The Cancer Control Act has promoted palliative services nationwide. Specialist care runs through palliative care wards, hospital teams, outpatient clinics and home care, with designated cancer hospitals ahead of community hospitals.^203,167

OpenHow large and widespread is specialist home palliative care today?

The 2021 regional atlas reports how widely each type of service is spread on an ordinal scale, so those values are not counts and are not shown as counts here.⁴⁸

OpenHow many specialised palliative care services operate in Jordan, and what is the rate per 100,000 people?

• 78 services Palliative care services identified, Kenya, 2023⁶³
• 0.15 per 100,000 Palliative care services per 100,000 population, Kenya, 2023⁶³
• 11 hospitals Provincial hospitals with integrated palliative care units, Kenya, 2016⁶¹
• 30,000 patients, cumulative lower bound Patients served by the integrated hospital units, Kenya, 2016⁶¹

Growth ran through public hospitals: a 2010 ministry circular directed provincial hospitals to set up palliative care units with the national association, later extended to further county hospitals. A western Kenya survey found limited training and opioid prescribing experience among frontline clinicians.^61,63,64

OpenHow are services distributed across the counties today?

• 0.09 per 100,000 Specialised palliative care services per 100,000 population, Lebanon, 2020⁴⁹
• 95.80 percent Adults surveyed in Tripoli who had never heard of palliative care, Lebanon, 2023¹⁴¹

Service density ties for the highest in the region, but services sit mainly in the capital. The second city had none, and almost no one surveyed there had heard of palliative care.^49,141

OpenHow many services operate outside Beirut after the crisis?

• 12 facilities of 13 Southern region facilities with an established palliative service after the programme, Malawi, 2012¹⁰⁴
• 463 patients Palliative patients receiving morphine at programme facilities, Malawi, 2012¹⁰⁴

Care runs through specialist hospital clinics, district hospitals and community care. A funded southern region programme established services in most participating facilities within about a year.^104,105

OpenHow many district hospitals nationally now run a palliative service?

• 7 hospitals Ministry of Health hospitals with a resident palliative medicine specialist, Malaysia, 2019⁴⁶
• 4 hospitals Ministry of Health hospitals with an inpatient palliative care unit, Malaysia, 2019⁴⁶
• 29 teams Registered community-based palliative care teams, Malaysia, 2024⁴⁷
• 31 percent Public primary care clinics offering domiciliary palliative care, Malaysia, 2024⁴⁷
• 25.80 percent Ministry of Health hospitals with a formal palliative care service, Malaysia, 2023¹⁵¹

The 2019 national policy review also counted four public teaching hospitals and five private hospitals with specialist services. Access is uneven: palliative services are close at hand in the central peninsula but far away in East Malaysia.^46,47,151

• 1.88 rate ratio Dispensing rate, higher against lower socioeconomic status states, Mexico, 2019⁹⁵

Dispensing was markedly higher in states of higher socioeconomic status, even after controlling for need.⁹⁵

OpenHow many palliative services exist, and how are they spread across states and public subsystems?

• 36 units Palliative care units nationally, Mongolia, 2017⁹⁴
• 190 beds Palliative care beds nationally, Mongolia, 2017⁹⁴
• 21 provinces of 21 Provinces with palliative beds, Mongolia, 2017⁹⁴
• 50 beds Hospice beds in six Ulaanbaatar hospice units, Mongolia, 2017⁹⁴

Care runs through hospital-based units: hospice units in the capital plus a small palliative bed allocation in every capital district and every province. A paediatric inpatient unit opened in 2014.⁹⁴

OpenIs there a tier below the provincial centres, such as home teams reaching herding communities?

The regional survey places Morocco in the lower development cluster with Egypt, Iraq, Iran and Pakistan, but high on vitality, with a national scientific association and a published directory of services.⁴⁹

OpenHow many palliative units and home teams exist under the current cancer plan, and where? Counts attributed to the previous plan were seen only in search summaries.

• 5 hospices Dedicated hospices for cancer patients, Nepal, 2021⁵³
• 4 units Palliative care units in major cancer hospitals, Nepal, 2021⁵³

Services are concentrated in the Kathmandu valley. The exceptions named in the literature are the cancer hospital unit at Bharatpur, the Janakpurdham programme opened in 2018, and Green Pastures Hospital in Pokhara, providing palliative care since 2009. WHO classes Nepal as isolated provision.⁵³

OpenWhat is the service count after 2021, and what caseload reaches patients outside the valley?

• 8 centres Palliative care centres at tertiary institutions facilitated by the national association, Nigeria, 2016⁶⁶
• 13 staff Palliative care staff per unit, median across five tertiary sites, Nigeria, 2023⁶⁶

Care runs through consultative units in federal teaching hospitals, described as isolated services rather than a network. Five surveyed units, established between 2001 and 2012, each offered inpatient, outpatient and home-based care.^65,66

OpenHow many units and home teams operate, and in which states?

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

OpenHow is palliative care delivered outside large private tertiary hospitals, for example in public hospitals and rural districts?

• 54 specialists Active hospice and palliative medicine specialists, Philippines, 2025⁸¹
• 0.05 per 100,000 Hospice and palliative medicine specialists per 100,000 population, Philippines, 2025⁸¹
• 8 regions of 17 Regions with no hospice and palliative medicine specialist, Philippines, 2022⁸⁰

Specialists concentrate in the capital region and a few cities, with none in several island provinces and a Mindanao cluster. Care was formally integrated across the health system in 2021, yet access remains fragmented and hospital based.^80,81,83

OpenHow many palliative teams operate by region, and what reaches patients through community health workers?

An NGO has led development since 1992, building home, inpatient, day-care and hospital-support services. Most specialist services are inpatient units. A 2018 Ministry of Health regulation includes home care, yet home services for children remain largely missing.^189,193

OpenHow far has home and hospital-team coverage grown since the 2018 regulation, outside NGOs?

• 252 patients Patients identified for palliative care at three study hospitals, Rwanda, 2014⁵⁷

Care is organised in a strict sequence from village community health worker to health centre, district hospital and national referral hospital, with no self-referral. After the 2011 policy the ministry began training a separate home-based care practitioner cadre.^57,58

OpenHow many home-based care practitioners are deployed, and across how many districts?

• 0.09 per 100,000 Specialised palliative care services per 100,000 population, Saudi Arabia, 2020⁴⁹
• 3.32 adjusted odds ratio Odds of palliative care access, high-income against low-income cancer patients, Saudi Arabia, 2026⁸⁹

The regional survey rated Saudi geographic spread the best in the region, with hospital teams, inpatient units, home care and outpatient clinics. A Riyadh study found access concentrated in central tertiary settings, with income and region compounding the gap.^49,89

OpenHow far does the ministry's home health care programme reach outside the major cities?

• 594 beds NGO intermediate care beds funded by the provincial department, Cape Metro, South Africa, 2021¹³⁰

Care grew through NGO hospices under a national association founded in 1987. The 2017 policy moved integration into public primary care and hospitals, achieved partially in the Cape Metro through provincially funded NGO beds and multidisciplinary teams.^133,130,131

OpenHow many NGO hospices and public palliative units operate nationally, and where?

The 2018 hospice and life-sustaining treatment act created national and regional hospice centers covering hospice, hospital and home care, but it limits eligibility to a short list of diseases and has no community service mandate. Consultative hospice teams have been piloted in acute wards since 2017.^{208,209,79,210}

OpenSources differ on whether the act dates from 2016 or 2018 and on which diseases qualify. Which is correct today?

Catalonia's program began as a WHO demonstration project with the regional health department and built home, hospital, inpatient, outpatient and psychosocial teams. In 2011 it widened to advanced chronic conditions with a tool to identify people in need. Across Spain, regional plans were followed by growth in services.^225,226,227

OpenWhat is national coverage and regional variation today?

• 217 nurses Public health nursing officers nationally, Sri Lanka, 2025⁷⁵

Services sit in selected tertiary hospitals, such as the palliative clinic at the national cancer hospital. The national strategic framework for 2019 to 2023 pushed home-based care, carried by public health midwives and a public health nurse cadre reintroduced in 2018.^76,75

OpenHow many hospital or district palliative teams exist nationally?

Services grew mainly through faith-based hospital networks and the national cancer institute, with village outreach from some rural hospitals.¹⁰⁰

OpenHow many palliative services operate nationally?

• 61 networks District health system palliative networks funded by the National Health Security Office, Thailand, 2015¹¹⁵

Care is organised through the district health system, linking community hospitals, subdistrict health centres and home visits, under a 2014 ministry policy extended to homes from 2016. Local models add community caregivers, and one hospital's model has scaled across provinces since 2020.^115,116

OpenHow many hospital palliative units exist by province, and what is the formal role of village health volunteers?

• 415 centres Palliative care centres, Turkiye, 2020³⁹
• 5,577 beds Palliative care bed capacity, Turkiye, 2020³⁹
• 0.48 services per 100,000 Specialised palliative care services per 100,000 people, Turkiye, 2025⁴⁰

Growth ran through inpatient units inside the ministry system and through home care teams together, across all provinces.^39,40

• 226 facilities Accredited palliative care facilities, Uganda, 2020³⁵
• 30 districts of 135 Districts with no accredited facility, Uganda, 2020³⁵
• 88.50 percent Population living in a district with a service, Uganda, 2020³⁵
• 68.10 percent Accredited facilities in the public sector, Uganda, 2020³⁵

OpenWho staffs the accredited facilities, and how many carry a certificated prescriber?

Palliative and hospice care began through NGOs with international donor grants. Family doctors carried home care where no mobile team service existed. The war has damaged community services and home care is often unavailable.^195,194,198

OpenHow many mobile teams and hospices operate now, and where?

In England, community palliative care is free at the point of delivery, from general practitioners, community nurses and specialist nurses employed by hospices or NHS trusts. Deaths are shifting from hospital to home and care homes, and longer travel time to a hospice means fewer hospice deaths, especially in rural areas.^245,247,248

OpenDoes access to specialist palliative care differ by diagnosis, deprivation or ethnicity across the UK?

Hospital palliative care programs grew to near-universal coverage in large hospitals, but access depends on geography and ownership. Specialist physicians are concentrated in cities and inpatient care, and deaths have shifted from hospital to home and community settings.^260,261,262

OpenHow large is community and home-based palliative care outside hospice?

• 15 hospitals Hospitals offering palliative care, Vietnam, 2010¹⁴⁶

The 2010 circular moved outpatient dispensing beyond the hospital, which the national situation report treats as the precondition for cancer patients holding opioids at home. Hospitals offering palliative care grew several-fold during the reform period.^44,146

The first National Palliative Care Strategic Plan launched in May 2021, and palliative care sits in the National Health Strategic Plan. Faith agencies provide a large share of care, and donor-supported hospices expanded home-based services.^186,57,184

OpenHow far has the 2021 strategic plan reached below hospital level?