With an estimated 29 000 children in Bangladesh needing specialised end of life care each year, there are presently only 2 doctors consistently providing children’s palliative care in this impoverished country.

The Children’s Palliative Care Initiative Bangladesh (CPCIB) is an initiative of World Child Cancer, which aims to support the development of palliative care services available for children with life limiting conditions throughout Bangladesh over a period of 5 years, beginning in January 2016 and ending in December 2020. The International Children’s Palliative Care Network (ICPCN) has agreed to provide technical assistance with the project over this period as well as assist with funding.

The project, which began in January of this year, will work in partnership with local palliative care health care facilities and organisations, and will support the development and implementation of a broad range of palliative care initiatives, focussing on three key pillars:

  1. Awareness and Advocacy Activities
  2. Education and Training
  3. Service Provision through Model Centres for Children’s Palliative Care

Awareness and Advocacy
Advocacy and awareness raising activities will increase knowledge and acceptance of palliative care among the general public of Bangladesh and health care providers, strengthen medical referral systems to increase the number and timeliness of referrals to palliative care and advocate with government officials for the integration of palliative care into Bangladeshi National Health Policies.  To achieve this, leaflets and posters about CPC will be developed and disseminated, seminars held, a website developed to act as a repository of local materials and meetings will be held with policy makers to advocate for the inclusion of palliative care into National Health Care Plans and policies.

Education and Training
Through education and training it is hoped the knowledge, skills and capacity of health care providers and parents to provide children’s palliative care will be developed. Activities under this pillar will include capacity building workshops for health care providers, support for the professional development of children’s palliative care specialists through regional collaboration and clinical placements and the development of clinical guidelines and care pathways adapted to local needs.

Model Centres of Care
Service provision will be through Model Centres for Children’s Palliative Care where high quality CPC will be provided that improves the quality of life for children and families while showcasing palliative care services for children in Bangladesh and mentoring of newly developed services. At these centres formal assessments will be done on the needs of children requiring palliative care as well as the provision of specialist palliative care which would include inpatient, outpatient and home care services.

Expected Outcomes
At the end of the five year period, the expected outcomes of this project are listed as follows:

  • Development and implementation awareness activities to increase knowledge and referrals for Children’s Palliative Care
  • Increased knowledge, skills and capacity of HCP and parents about Children’s Palliative Care
  • Model Centres provide high quality Children’s Palliative Care which is appropriate for Bangladesh, and improves the quality of life for children with life limiting conditions and their families

Seminar and Capacity Building Workshop on Palliative Care in Dinajpur
As part of this far reaching project a seminar and capacity building workshop on palliative care took place on 29 and 30 March 2016 at Lamb Hospital Training Centre in Dinajpur in Northwestern Bangladesh and was attended by 10 nurses, 7 doctors, 7 Physician Assistants, 7 Training Centre Staff and 10 Chaplains. The seminar was well received with participants reporting that the most important things they learned as:

  • Pain Management and about oral morphine
  • Self care
  • Wound care
  • Communication skills, especially how to listen to patients
  • Pain Assessment Techniques
  • Community based PC models
  • How to give hope, but also be honest, breaking bad news
  • Spiritual, social and psychological needs of palliative care patients
  • Palliative care facilities in Bangladesh
  • What is palliative care and how it can help patients with NCD/chronic diseases

The trainers for this workshop were Dr. Megan Doherty (Project Lead for the Children’s Palliative Care Initiative Bangladesh), Dr. Jameela Khan (Dhaka Medical College Hospital), Dr. Shahinur Kabir (Hospice Bangladesh), Dr. Nezamuddin Ahmad (Centre for Palliative Care, BSMMU), Ms Lailatul Ferdous (nurse, Centre for Palliative Care), Ms Farhana Aktar (nurse, Centre for Palliative Care).