Palliative Care Services in Childhood Cancer in Bangladesh: Current Situation and Challenges

Abstract

Background: Palliative care is a major priority in childhood cancer care strategy as it provides compassionate support both for the children and their families.

Objective: The aim of the present study was to observe the current situation of palliative care services in childhood cancer in Bangladesh and its challenges.

Methods: An anonymous survey was done between July and December of 2013 in some specialized pediatric oncology units of different public and private hospitals in Dhaka city of Bangladesh, based on a semi‐structured questionnaire. A total of 300 respondents including physicians, nurses, caregivers, hospital managers who deal with childhood cancer, and parents of children suffering from cancer took part in this survey. Queries addressed are access to treatment, availability of drugs, palliative care, pain management, cost of treatment, quality of care and perceived challenges.

Results: Difficulty in access to treatment (86%), out‐of‐pocket payment for oncology therapies (88%), palliative care (91%) were evident. 93% reported that availability of specialized palliative care services, pain management and psychological plus decision‐making support were directly related to income level. Overall, 96% of respondents indicated that palliative care is important for their patients and 79% indicated that they were competent to provide this care; however, only 64% indicated that they had enough time to deliver quality palliative care. Challenges include lack of awareness, less availability of facility, high cost, limited and inefficient manpower, low quality of care, less communication between health professionals and parents/family members of the patient.

Conclusion: In Bangladesh, pediatric oncology is usually practiced in resourcestrained oncology units of pediatric divisions in different public hospitals along with few private hospitals. However, this survey confirmed that many of the children lack access to quality palliative care. Effective palliative care requires establishment of more facilities with cancer registry, availability of drugs for therapies and pain management, manpower development, communication with patients and families in decision‐making.

International Journal of Human and Health Sciences Vol. 05 No. 02 April’21 Page: 226-229