Assessing Palliative Care Development in Mexico through the WHO Actionable Indicators Model.
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CONTEXT: Assessing the development of palliative care (PC) is essential to advancing PC delivery worldwide. The World Health Organization (WHO) offers a new conceptual model for assessing PC development that focuses on identifying gaps in service provision, which helps define priorities and guide decisions. Previous reports ranked Mexico at a high level of PC development, described as an early integration stage in the health system. However, this updated framework offers a more profound and holistic analysis by providing previously unavailable data. OBJECTIVES: To document the current state of PC development in Mexico through the WHO actionable indicators model. METHODS: Six components were measured: a) PC provision; b) use of essential medicines; c) education and training; d) research; e) health policies; and f) empowerment of people and communities. Fourteen indicators were individually ranked into four levels of development: 1) emerging, 2) intermediate, 3) established, and 4) advanced. RESULTS: Mexico's PC development has focused on specialization streams for physicians, increased awareness through scientific conferences, publications, and community organizations, and the inclusion of PC in the national basic health package and national and local laws. In contrast, PC development is halted by insufficient PC services, a lack of a national PC authority, association, or plan, limited access to essential medications, and scarce undergraduate education. CONCLUSIONS: This study shows a regression in the level of PC development in Mexico through an updated analysis, highlighting the gaps that need to be urgently addressed. These findings help continue PC advocacy, growth, and implementation in the region.
