589: Scaling Palliative Care Capacity in North India: A Multicenter Capacity Building Model

Topic: Education, Societal Impact, and Others
Subtopic: Other (please describe), Education and Society Impact with capacity building

Background and Aims: Palliative care (PC) provision in Northern India remains limited and uneven despite a steadily increasing need. The demand for specialized care that prioritizes quality of life is urgent, driven by factors like an aging population and a significant rise in noncommunicable diseases. In this context, PC providers frequently lack adequate training, institutional support, and interdisciplinary collaboration indispensable for effective implementation of PC. This study analyzes the effectiveness of a PC capacity-building project executed from 2023 through 2025. The aim was to present scalable approaches to enhance PC competencies, overcome existing barriers, and expand PC infrastructure in Northern India.

Methods: The project was conducted in three phases. Phase I focused on the selection and development of nine centers of excellence that had existing PC services. These centers were assessed twice (February and August 2023) to track changes in palliative care development and consistency. Phase II aimed to associate each of the nine centers with ten district hospitals. Phase III aimed at training two doctors and two nurses each from the 90 district hospitals in PC. Their knowledge was evaluated using the PC Knowledge Test (PCKT) and the AIIMS Knowledge Tool (AIIMS KT) before training, after training, and again six-month later.

Results: Nine centers of excellence reported substantial foundational capacity and demonstrated continued improvements in PC delivery, including noted improvements in systematic record-keeping. The mean number of OPD patients per month increased from 125.56 to 152.89 between the two initial assessments. 324 physicians and nurses received PC training. They showed significant knowledge gains after the palliative care training. Mean scores on both the PCKT and AIIMS KT improved significantly from the pretest to the post-test (P<0.001), and these scores remained significantly higher than baseline levels at the six-month follow-up even after adjustment for age, gender, profession, and experience.

Conclusions: This project illustrates that this three-phased capacity-building initiative significantly enhanced PC services. The model not only improved institutional PC implementation and record-keeping but also resulted in measurable, lasting gains in providers' knowledge, confirming the effectiveness of the educational intervention. The project’s success, achieved through institutional outreach and targeted training, demonstrates a scalable model for PC expansion. For India to meet the growing demand for PC, continued training and formal integration of PC education within curricula and service provision, combined with supportive institutional and national policies, are essential.

References: Rao SR, Salins N, Goh CR, Bhatnagar S. Building palliative care capacity in cancer treatment centres: a participatory action research. BMC Palliat Care 2022;21:101.

Presenting Author: Dr Sushma Bhatnagar
Submitting Author: Sushma Bhatnagar

Senior Author: Dr Sushma Bhatnagar

IASP 2026 Global Year theme of Neuropathic Pain: No