Community health workers in palliative care provision in low-income and middle-income countries: a systematic scoping review of the literature
Title
Community health workers in palliative care provision in low-income and middle-income countries: a systematic scoping review of the literature
Creator
MacRae M C; Fazal O; O'Donovan J
Identifier
Publisher
BMJ Global Health
Date
2020
Subject
children; palliative care; India; methods; Developing Countries; Asia; health care; recommendations; Chordata; eukaryotes; Hominidae; Homo; human diseases; mammals; man; primates; vertebrates; animals; Commonwealth of Nations; sustainability; methodology; systematic reviews; allied health occupations; community health; effects; grey literature; guidelines; health services; health workers; literature reviews; medical auxiliaries; Newly Industrialized Countries; NICS; non-conventional literature; South Asia; techniques; Third World; threshold countries; Underdeveloped Countries; workers
Description
Background: Community health workers (CHWs) are currently deployed in improving access to palliative care in a limited number of low-income or middle-income countries (LMICs). This review therefore aimed to document evidence from LMICs regarding (1) where and how CHWs are currently deployed in palliative care delivery, (2) the methods used to train and support CHWs in this domain, (3) the evidence surrounding the costs attached with deploying CHWs in palliative care provision and (4) challenges and barriers to this approach. Methods: We conducted a systematic scoping review of the literature, adhering to established guidelines. 11 major databases were searched for literature published between 1978 and 2019, as well as the grey literature. Findings: 13 original studies were included, all of which were conducted in sub-Saharan African countries (n=10) or in India (n=3). Ten described a role for CHWs in adult palliative care services, while three described paediatric services. Roles for CHWs include raising awareness and identifying individuals requiring palliative care in the community, therapeutic management for pain, holistic home-based care and visitation, and provision of psychological support and spiritual guidance. Reports on training context, duration and outcomes were variable. No studies conducted a formal cost analysis. Challenges to this approach include training design and sustainability; CHW recruitment, retention and support; and stigma surrounding palliative care. Conclusion: Despite relatively limited existing evidence, CHWs have important roles in the delivery of palliative care services in LMIC settings. There is a need for a greater number of studies from different geographical contexts to further explore the effectiveness of this approach.
Rights
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Citation List Month
Developing World 2020 List
URL Address
Collection
Citation
MacRae M C; Fazal O; O'Donovan J, “Community health workers in palliative care provision in low-income and middle-income countries: a systematic scoping review of the literature,” Pediatric Palliative Care Library, accessed April 23, 2025, https://pedpalascnetlibrary.omeka.net/items/show/17346.