Fernando GHS, Ismile MIS, Jayawickrama KLADSN, Jayalath GDT, Perera IS
https://orcid.org/0000-0001-7356-6257
Abstract
Palliative care is a critical yet often under-integrated component of healthcare systems in low-resource settings. It enhances the quality of life for patients with life-limiting illnesses and offers essential support to their families and caregivers. In Sri Lanka, palliative care services remain limited, particularly at the community level. To address this gap, a district-level initiative was undertaken in Monaragala to establish a sustainable, community-based palliative care system under the leadership of the Regional Directorate of Health Services. The initiative involved a context-specific gap analysis, formation of a steering committee, training of multidisciplinary teams, and deployment of a low-cost, digital patient management platform using open-access tools. Over a five-month period, six palliative care teams were established, and 19 patients were enrolled and effectively managed, demonstrating improved care coordination and responsiveness. This model not only reduced unnecessary hospital admissions and patient travel burdens but also strengthened local health system capacity by mobilizing underutilized staff and infrastructure. The project highlights the role of community-based palliative care in building health systems resilience by improving continuity of care, optimizing resources, and fostering adaptability. It offers a replicable approach for other districts in Sri Lanka and similar low-resource settings. It is recommended that the Ministry of Health facilitate the development of a centrally guided, locally implemented national framework for palliative care to ensure equitable, accessible, and resilient service delivery.
Key words: Palliative Care, Community-Based Palliative Care, Health Systems Resilience, Primary Healthcare, Sri Lanka