How children get palliative care, by country

At the Pedro de Elizalde children's hospital in Buenos Aires, the palliative care team started morphine in 57 of 72 children with mixed pain and rotated to methadone when needed. The Argentine Pediatric Society's palliative care committee has issued a consensus guide on forgoing life-sustaining treatment that centers the child's best interest and parental dignity.^748,749

OpenHow many pediatric palliative care teams operate across Argentina's provinces, and how many children do they reach each year?

Armenia's National Strategy on Improving Child and Adolescent Health explicitly recognizes and defines pediatric palliative care, according to an advocacy-authored case study.¹⁵⁶

OpenAre there operating pediatric palliative care services in Armenia, and how many children do they reach?

In Queensland, hospital admissions of young people with life-limiting conditions rose 29.6% from 2011 to 2016, including rises of 36.2% for non-cancer conditions and 70.2% for Indigenous young people. A national collaborative trains regional professionals so children can be cared for at home. Parents of children with non-cancer conditions reported greater support needs.^691,692,693

OpenHow many children with life-limiting conditions across Australia are reached by specialist pediatric palliative care each year, and does access differ for Indigenous and rural children?

A hospital pediatric palliative care pilot in Dhaka served 200 children with cancer in 2014 to 2015, with psychosocial support the most common intervention and morphine the most prescribed medicine. A community program in the Korail informal settlement gives children free home care from trained community health workers, including medicines, equipment and psychosocial support.^562,373

OpenHas the Dhaka hospital pediatric palliative care service continued beyond the pilot, and how many children does it reach each year?

Among 272 Brazilian physicians treating children with cancer, 77.2% had access to pediatric palliative care experts, but only 10.3% said palliative care began at diagnosis. Top barriers were physician discomfort (89.0%), limited knowledge (88.6%) and lack of home-based services (83.8%).⁷⁵⁰

OpenHow many children with life-limiting conditions in Brazil receive specialist palliative care, and are oral morphine solutions available for children in public pharmacies?

From 2008 to 2014, 74.2% of Canadian children and 98.1% of neonates with life-threatening conditions died in hospital, with more hospital deaths among low-income families. In Ontario, children in a region with specialist pediatric palliative care had fewer health care days, fewer ICU days, lower costs and lower odds of dying in hospital.^698,699

OpenHow many children with life-limiting conditions in each province receive specialist pediatric palliative care, and what supports exist for families far from pediatric centers?

At Hospital Roberto del Río in Santiago, two thirds of 99 children with advanced cancer in the palliative care program needed strong opioids, and pain was controlled under a protocol without serious complications. In a survey of 78 Santiago pediatricians, 29.5% had palliative care training and 47.7% had ever referred a child to a pediatric palliative care team.^744,745

OpenHow many children with non-cancer life-limiting conditions in Chile receive specialist palliative care, and are oral liquid morphine formulations available outside Santiago?

A 2025 census counted 36 pediatric palliative teams covering 16 of 31 provinces, down from 45 teams in 2019, while total team members rose from 300 to 513. Among 368 physicians treating children with cancer, 29.4% had palliative training and 42.7% felt burdened by their inability to control children's suffering at end of life.^672,673

OpenAre child-appropriate opioid formulations on the Essential Medicines List, and how many children do the 36 teams reach each year?

At one tertiary hospital, only 10 of 87 children who died were treated by the pediatric palliative care team; those children more often died with comfort measures and less often received resuscitation. Pediatric palliative care is not in health professional curricula, and a virtual toolkit trained 145 professionals from 22 centers.^735,736

OpenHow many pediatric palliative care services operate nationally, and how many children do they reach?

A single national pediatric palliative care program, founded in 1990 at the National Children's Hospital, serves about 1300 children, 60% with central nervous system conditions and 15% with cancer. It offers inpatient consults, home visits across the country and a day hospital, supported by the Costa Rica Social Security System and a foundation.^319,743

OpenHow does Costa Rica ensure child-appropriate opioid formulations reach children at home in remote regions, and how are consent and disclosure handled with adolescents?

The National Cancer Institute in Cairo launched Egypt's first outpatient palliative care service for children with cancer in late 2007 and added home care in 2010, while no pediatric palliative care guideline existed. In Port Said, 76.8% of 500 family caregivers of children with cancer showed inappropriate palliative care practice.^625,440

OpenHow many children in Egypt receive palliative care each year, and are oral morphine formulations for children available outside Cairo?

Georgia has six state-funded pediatric palliative care units and one non-state-funded children's hospice, Firefly World, which opened in 2017.^154,152

OpenHow many children do these services reach each year, and which oral opioid formulations are available for children?

Children with life-limiting conditions and complex symptoms are eligible for specialized outpatient palliative care delivered by teams with pediatric expertise. Studies in Hesse found access is often difficult for families and a care gap for children who need home palliative care that is less intensive. Siblings aged 11 to 17 in a large home care program reported lower quality of life than national norms.^719,720,721

OpenHow many children receive specialized pediatric palliative home care in Germany each year, and how evenly are teams spread across states?

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

OpenHow many children receive pediatric palliative care in India each year, and are child-appropriate oral morphine formulations available at those services?

Rachel House provides nurse-led home-based pediatric palliative care in Jakarta, and families of 12 children with cancer described holistic, family-centered support. At one academic hospital, all 49 children who died of cancer died in hospital although 37% preferred home, and 46% of children with depression received no intervention.^578,579

OpenHow many children in Indonesia receive palliative care each year outside Rachel House, and are oral morphine formulations for children available?

Pediatric palliative care centers in Iran remain underdeveloped; the Mofid Children's Hospital clinic, opened in 2021, offers 24-hour in-person and telephone services. Pediatricians describe difficulty telling children and families the truth about disease and conflicts between physicians and parents.^647,648

OpenHow many children receive specialist palliative care in Iran, and which child-appropriate opioid formulations are available?

An estimated 12% of children with cancer in Japan used hospital palliative care teams in 2015, and few teams had experience with children with non-cancer conditions. Care for non-cancer conditions is less developed, and most of these children die in hospital under intensive care. Families' wishes tend to come before the child's in decisions.^678,679

OpenHow many children with non-cancer life-limiting conditions receive palliative care, and what is actual pediatric strong-opioid use now that national open data suppress most pediatric counts?

Jordan's first children's palliative care service opened at King Hussein Cancer Center in 2005, offering outpatient, inpatient and home care with 24/7 phone support. At one tertiary cancer center, parents often hid information from sick children and asked clinicians to do the same, while children hid their suffering to protect their parents.^625,632

OpenHow many children receive palliative care in Jordan outside King Hussein Cancer Center, and what rules govern consent and disclosure for minors?

Across eight tertiary hospitals in four East African countries, four of them in Kenya, oral morphine was among the childhood cancer medicines with frequent stockouts, and a Kisumu hospital had the highest mean unavailability at 48.5%. Children with life-limiting conditions in Kenya and three other countries named pain, family relationships, play and school, and worry about death as outcomes that matter.^584,585

OpenHow many children receive palliative care in Kenya, and which services beyond tertiary hospitals serve them?

Pediatric palliative care delivery and fee coverage emerged through a partnership with the Children's Cancer Center of Lebanon. A 2013 study at that center found symptom management was inadequate and focused mainly on physical symptoms, and liquid or granule immediate-release morphine has been unavailable.^327,639

OpenHow many children receive palliative care each year, and are child-appropriate oral opioid formulations now registered?

Malawi was the first African country with specialist palliative care services for children, and the Umodzi program is integrated into pediatric care. A Lilongwe pediatric hematology-oncology palliative program enrolled 315 patients over three years, and 53% of deaths occurred at home. Caregivers of children with cancer describe stigma and need psychosocial, spiritual and financial support.^103,593,594

OpenHow many children receive palliative care in Malawi outside Blantyre and Lilongwe, and which oral morphine formulations are available for them?

Of 8907 child deaths in Ministry of Health hospitals in 2012 to 2014, 3958 (44.4%) were children with life-limiting illness, and 63.9% of those were neonates. Paediatric palliative care developed later than adult care, first through individual paediatricians and NGOs, and still faces a shortage of trained paediatricians.^659,660

OpenHow many children receive specialist paediatric palliative care each year, and are pediatric opioid formulations stocked?

Of 37,444 child deaths in Mexico in 2021, 10,677 were from conditions with serious health-related suffering, and no state had early or advanced pediatric palliative care integration. Professionals rate lack of awareness and commitment, lack of support and legal factors as the most severe barriers.^741,742

OpenHow many children are reached by pediatric palliative services, and which oral opioid formulations for children are available?

A five-bed pediatric palliative inpatient unit opened in 2014. Mongolia was one of 11 countries in a 2019 survey of physicians treating children with cancer, where 64% across the region said palliative consultation typically starts only when curative options run out.^94,664

OpenHow many children does the pediatric unit serve each year, and are child-appropriate opioid formulations available outside Ulaanbaatar?

A 2012 account from pediatric oncology reported that opioid therapy was available but strongly limited by restrictive and obsolete legislation, and that palliative care for children was not yet organized. Experts surveyed in 2020 reported only isolated pediatric palliative care provision in Morocco.^628,49

OpenHow many Moroccan children with life-limiting conditions now receive palliative care, and has the opioid legislation been updated?

Online Project ECHO courses in pediatric palliative care have trained Nepali physicians, nurses and psychosocial counselors, with significant gains in knowledge and attitudes. One course enrolled 55 clinicians over 22 sessions, and 93% rated it effective learning.^569,570

OpenHow many children in Nepal receive pediatric palliative care, and at which hospitals is a dedicated pediatric team available?

A 2026 scoping review found only 10 dedicated pediatric palliative care centers, with most children with life-limiting illness managed in general wards, and 52% of surveyed providers had never prescribed morphine. Two structured psychoeducation sessions for family caregivers of children with cancer in four tertiary hospitals reduced caregiver burden and unmet needs.^612,613

OpenAre child-appropriate oral morphine formulations available outside tertiary hospitals, and what rules govern consent and disclosure for children?

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

OpenHow many children in Pakistan are reached by pediatric palliative care each year, and are oral morphine formulations for children available at those centers?

A 2025 mapping of 54 hospice and palliative medicine specialists found pediatric palliative services inconsistent nationwide. A 2025 conference report described a Pediatric Palliative Care Unit at the National Children's Hospital and formal recognition of children's palliative care as a specialty by the Philippine Pediatric Society.^81,662

OpenHow many children with life-limiting conditions are reached each year, and are pediatric opioid formulations available outside Metro Manila?

Child protection data identified 14,499 children with palliative care needs in 2022 to 2023, more in rural than urban areas, and prior reports cite only 50 pediatric palliative beds. There is no dedicated national strategy, and pediatric oncology staff name understaffing, stigma and emigration of skilled staff as barriers.^730,520,193

OpenHow many children actually receive specialist palliative care each year, and which child-appropriate opioid formulations are available?

At Butaro Cancer Centre of Excellence, childhood cancer medicines were unavailable 39.0% of the time over a year of tracking, and oral morphine was among the medicines with frequent stockouts across sites. In a Butaro cohort of 136 children with nephroblastoma, 4.4% were referred to palliative care or declined further care.^584,587

OpenDoes Rwanda have dedicated pediatric palliative care services or child-appropriate opioid formulations outside Butaro?

Among 302 child deaths at one tertiary center, the palliative care team was involved in only 27.9%, and most children died in intensive care. In a multi-center survey, 9.13% of healthcare workers had formal pediatric palliative care training.^651,652

OpenHow many dedicated pediatric palliative care teams exist, and which oral opioid formulations for children are available?

A UNICEF and ICPCN assessment estimated that less than 5% of children needing palliative care in South Africa received it, with fear of opioid use among the barriers. Families of children with cancer at one Bloemfontein hospital reported erratic psychosocial support and no support for siblings.^620,621

OpenWhat is pediatric palliative care coverage since the 2017 national policy, and are oral morphine formulations for children stocked in primary care?

A government pediatric palliative care project runs through ten hospitals. All nine hospitals surveyed offered counseling, education and bereavement care, but only one offered respite care. At one children's hospital, specialized palliative care was linked with earlier advance care planning, less mechanical ventilation or resuscitation, and more opioid use at end of life.^684,685

OpenHow many children with life-limiting conditions nationally are reached by the ten project hospitals, and what pediatric opioid formulations are available?

In a 10-center study of 228 children who died of brain tumors, 52.2% were attended by palliative care teams and 81.6% received opioids. Families and professionals asked for specialized pediatric units, continuity of the medical team and 24 h pediatrician care.^726,725

OpenHow many pediatric palliative care teams operate across Spain's regions, and how many children do they reach each year?

Among 120 children with cancer at Bugando Medical Centre, 68.33% had poor access to supportive care medicines, mainly due to cost and limited insurance. Caregivers and staff there described financial, knowledge, cultural and communication barriers to end-of-life care, including views on children's pain.^591,592,584

OpenDoes Tanzania have pediatric palliative care services outside referral hospitals, and are child-appropriate morphine formulations available?

The first palliative care unit for children opened at Dokuz Eylul University in 2011, and by February 2020 there were 10 paediatric palliative care services with 119 beds. Paediatricians working in hospitals with a paediatric unit felt competent in pain management far more often (36.8% vs 6.4%).^39,636

OpenWhich oral morphine formulations suitable for children are available, and how many children do paediatric services reach each year?

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}

OpenHow many children receive palliative care in Uganda each year, and are child-appropriate morphine formulations stocked outside referral hospitals?

The pediatric oncology foundation Tabletochki runs palliative care programs and helps arrange medical evacuation for children with cancer. A legal review reports that children's rights to palliative care at home, to consent to care, and to confidentiality are violated in practice.^194,714

OpenHow many children in Ukraine receive palliative care each year, and are oral morphine formulations for children available?

The prevalence of life-limiting conditions in children in England rose from 26.7 to 66.4 per 10,000 between 2001/02 and 2017/18. Among 39,349 young people with these conditions who died, 73% died in hospital, 6% in a hospice and 16% at home, and ethnic minority and more deprived children were less likely to die in a hospice.^703,704

OpenWhat share of children with life-limiting conditions in England receive specialist palliative care, and are pediatric formulations of key symptom medicines reliably available in the community?

Among 54 US inpatient pediatric palliative care programs in 2018, only 37% met minimum staffing standards and 60% could not meet clinical demand. Medicaid concurrent care lets children in hospice continue curative treatment, but states implement it in widely varying ways.^708,709,710

OpenWhat share of the more than 55,000 US children who die each year receive pediatric palliative care or hospice, and how many children with private insurance have access to concurrent care?

Vietnam's first pediatric palliative program opened in 2017 at a major children's hospital. In 18 months its consult service saw 169 children aged 0 to 15.6 years, with psychosocial support the most common intervention (70%) and pain management given to 28%.⁶⁵⁶

OpenAre child-appropriate oral morphine formulations and pediatric palliative services available outside the major children's hospitals?

The 2017 Africa palliative care atlas, cited in a review, counted four pediatric palliative care service outlets in Zambia. In a four-country survey that included 21 Zambian anesthetists, mostly in tertiary hospitals, respondents reported good availability of opioids for children, and Lusaka doctors described morphine use mainly for cancer and sickle cell disease.^595,596,187

OpenHow many children receive palliative care in Zambia, and are pediatric morphine formulations available outside Lusaka?