Situational analysis of the quality of palliative care services across India: a cross-sectional survey

OBJECTIVE: Palliative care services in India were established in the 1980s but there is no detailed up-to-date knowledge about the quality-of-service provision nationally. We aim to describe the current quality of palliative care provision in India, as measured against nationally adopted standards. METHOD: A digital survey adapted from the Indian Association of Palliative Care Standards Audit Tool was administered to 250 palliative care centres. RESULTS: Two hundred and twenty-three (89%) palliative care centres participated – 26.4% were government-run, while the rest include non-governmental organisations, private hospitals, community-led initiatives and hospices. About 200 centres ‘often’ or ‘always’ fulfilled 16/21 desirable criteria; however, only 2/15 essential criteria were ‘often’ or ‘always’ fulfilled. Only 5.8% provide uninterrupted access to oral morphine. SIGNIFICANCE OF THE RESULTS: Palliative care centres in India are falling short of meeting the essential quality standards, indicating the urgent need for new initiatives to drive national change.