Background: The International Observatory on End of Life Care is a new initiative that aims to provide comparative, research-based information on palliative care development in the international context, country by country - with a particular emphasis on resource poor settings. Issues. The work of the Observatory raises several methodological problems: a) how to combine epidemiological and public health data with historical, cultural and ethical analysis of hospice/palliative care provision b) how to identify nascent palliative care services in resource poor settings c) how to validate research findings.
Methodology: Observatory research designs combine qualitative and quantitative methods. We have developed: a) criteria for service identification b) a template for collating and comparing epidemiological, demographic and health system data across countries c) a structure for in-depth qualitative interviews - telephone/face to face d) a review method for published sources and grey literature e) a template for individual country reports f) a database of palliative care services and educational programmes in each country g) case study analysis of palliative care success stories h) an international network of collaborating colleagues i) a system for validation of findings j) a website for dissemination (www.eolc-observatory.net).
Discussion: The global analysis of palliative care development creates many challenges. Multi- method and interdisciplinary approaches are essential if we are to generate accurate data and worthwhile analysis.
Conclusion: The methodology adopted by the Observatory provides flexible, comprehensive and valid ways to identify and review hospice/palliative care services across countries.