Aim: To determine palliative care developments in 12 countries in Eastern Europe and Asia
Methods: A cross sectional survey by email questionnaire sent to a named recipient in each of 12 countries
Results: Provision: home care services (209/10 countries) and inpatient units (133/9 countries) feature most frequently. Paediatric services are sparse: 32/ 52 in Poland. Policy: guidelines for the management of acute pain and chronic cancer pain were found in 11/12 countries. Most countries (9/12) have a national cancer control policy and national AIDS policy (9/12) although these rarely include palliative care. Five countries have undertaken a palliative care needs assessment. Three countries have developed palliative care standards across a broad range of services; 6 countries have legislated for palliative care delivery in the four settings of hospitals, inpatient hospices, outpatient services and home care systems. Six countries have developed a palliative care certification program for doctors; 4/12 for nurses. The health care system reimburses home based palliative care in 3/12 countries; inpatient palliative care in 5/12 countries. Barriers include a) insufficient funding b) low social and professional awareness c) poor pain control d) the lack of trained staff e) the absence of legislation. Opportunities include a) the development of education programs b) ministerial support c) the development of national standards d) the increase in palliative care services/personnel e) better pain relief
Conclusions: The survey indicates a) a patchwork of palliative care provision and policy-making b) a general awareness of the barriers/opportunities for palliative care development.