Home Based Palliative Care in low and middle income countries
Serious illnesses cause significant suffering for millions of people each year. Palliative care helps manage this suffering and improve quality of life. However, many low- and middle-income countries (LMICs) have limited access to palliative care.
Home-based palliative care (HBPC) provides care to patients in their own homes. It can improve quality of life and reduce costs for both families and healthcare systems. However, there is limited guidance on how to develop and maintain HBPC services in different LMIC settings.
Researchers based at the Cicely Saunders Institute reviewed 42 studies from LMICs to identify what makes HBPC successful. They found five key factors:
- Community involvement: Local communities should be involved in developing and supporting services.
- Community health workers and volunteers: These workers can provide important care and support within the community.
- Strong nursing leadership: Nurses should have the skills and authority to lead and coordinate care.
- Well-trained healthcare teams: Different healthcare professionals need appropriate training and should work together.
- Ongoing support for family caregivers: Families need regular, practical and emotional support because they often provide much of the care.
These approaches can build trust, hope, confidence and reassurance among patients, families and healthcare workers. This can make HBPC easier to accept, more practical to deliver and more sustainable over time. Overall, the review suggests that LMICs developing HBPC services should focus on strong community involvement, skilled and empowered nurses, trained care teams and volunteers, and continuous support for families and caregivers.
Similar challenges in other countries mean that the same approaches could help introduce home-based palliative care (HBPC) in different resource-limited settings. Countries could also learn from each other’s experiences. To improve the success of HBPC, investment should focus on strengthening community support and giving nurses a stronger leadership role within multidisciplinary care teams.
Le DD, Duong KD, Peeler A, et al. Contexts, mechanisms and outcomes of home-based palliative care implementation in low- and middle-income countries: A realist review. Palliative Care and Social Practice. 2026;20. doi:10.1177/26323524261466691
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