Situational analysis of the Health and Wellness Centers (HWCs) to provide palliative care in Telangana, South India

Palliative Care (PC) aims to provide holistic care encompassing physical, psycho-social, and spiritual well-being to improve the quality of life of the patients and their caregivers. In India, PC is practiced in a scattered manner contributing to myths, and misunderstanding. Thus, it is necessary to integrate PC into primary care through the Health and Wellness Centers (HWCs). For appropriate treatment and referrals, it is required that the Health Care Providers (HCPs) have adequate knowledge. Hence, this study aims to identify the resources available in the selected HWCs in Hyderabad and Ranga Reddy districts in Telangana. It also seeks to evaluate the knowledge and barriers of the HCPs. A cross-sectional observational study was performed in the randomly selected 30 HWCs in both districts. A checklist was used to assess the resources available to provide PC. Qualitative In-depth Interviews (IDIs) and Focus Group Discussions (FGDs) were executed with the HCPs at the centers. Atlas.ti software was used to analyze the IDIs and FGDs. The lack of staff nurses, missing essential drug kits, and absence of home-based PC screening were identified. The respondents were unaware of PC as they did not receive any training. The interviews revealed that the Mid-level Health Providers (MLHPs) had a higher level of knowledge than the other staff. The HWCs are not yet well-equipped to provide PC at the centers and homes. New and modified training and sensitization programs must be implemented at the central and state levels.