Publication
Reducing inequity in the provision of children's palliative care in low- and middle- income countries: A focus on education and research
Downing J, Brand T, Daniels A, El-Khoury J, Gafer N, Palat G, Riga O, Szylit R, Garcia-Quintero X · Palliative Medicine · 2025
There are over 21 million children and their families globally who need palliative care,1 yet estimates suggest that less than 10% can access it. The greatest need for palliative care in children is in low- and middle-income countries, where 98% of the demand for palliative care in children exists, and access to services is limited. Indeed, in low-income countries there is a projected 5% increase in serious health-related suffering in children aged 5–14 years by 2060, despite a projected decrease globally in serious health-related suffering in children.2 Achieving equity in palliative care demands more than uniform provision of services; it necessitates a deliberate reallocation of resources to address the structural inequities that systematically disadvantage certain populations.3 The World Health Organization (WHO)4 defines equity as ‘the absence of unfair, avoidable or remediable differences among groups’ and emphasises that health is a fundamental human right. In the context of children’s palliative care, this principle requires a shift from aspirational rhetoric to concrete action, prioritising marginalised groups, dismantling barriers rooted in socioeconomic, racial and geographic disparities and embedding equity as a measurable outcome within service delivery and policy frameworks...
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