Local Government-led Community-Based Palliative Care Programmes in Kerala

Abstract

This paper highlights aspects of community-based palliative care programmes in Kerala inthe context of the increasingly aged population and the emergence of life style diseases.Kerala is the forerunner in community-based palliative care in India. With the involvement oflocal governments and public participation, the quality of palliative care programmes have.improved quite significantly. Kerala, traditionally renowned for its high quality of life, is alsoproving to be the best place to die with a high quality of death index due to the prevailingpalliative care programmes. Collating state level data available from the Information Kerala
Mission, the author validates that all the three grassroots levels of local governments inKerala, viz, the Grama Panchayats, Municipalities and Municipal Corporations are bestplaced to deliver palliative care services to the needy. A detailed account of palliative careprogrammes undertaken by Mullurkkara Grama Panchayat of Thrissur district, Kerala State,forms part of this article to give emphasis on the special role of local governments inpalliative care management. The Grama Panchayat has carried out various care servicesincluding home care visits, supply of medicines, supply of aids and appliances, constitution.
of home care teams, and the appointment of palliative care nurses. The absence of socialworkers in the home care teams, inadequate financial resources, low service convergence anda lack of concurrent monitoring of services are the major gaps found in the palliative careprogramme. The author confirms that within a few years of intensive implementation, theprogramme has proved to be a most cost effective and decentralised public health model.However, the sustainability of such programmes depends on the capacity to mainstreamcommunity volunteerism.