ideasIdea
Volunteer-led neighbourhood palliative networks, the Kerala model, adapted elsewhere
In Kerala, trained community volunteers, backed by nurses and doctors, provide most home palliative care to the dying. The model reaches more people at lower cost than any clinic-based service and could be copied.
The Neighbourhood Network in Palliative Care in Kerala trains community volunteers to identify patients, provide social and basic nursing support, and link to professional teams, with local government funding and a state palliative care policy. Coverage is far higher than elsewhere in India. Adapting this community-owned model in other states and countries requires local ownership, a light professional backbone, and reliable morphine supply rather than large budgets.
Hypothesis
Districts adopting a neighbourhood network model will achieve palliative care coverage of at least 50% of people dying with cancer within four years, compared with under 10% for clinic-based services.
Rationale
Community mobilisation delivered coverage in Kerala where health-system approaches did not; the ingredients are documented and transferable.
What would test it
Implementation in ten districts across three countries with coverage, home-death rates where preferred, and caregiver-reported quality of dying as endpoints.
Maturity
being tested at scale
Who has to act
patients
Cost to try
Small (under $1M)
Years to first evidence
3
Bottlenecks it attacks
- Pain relief and palliative care are unavailable to most · Most people who die of cancer worldwide do so without adequate pain relief.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.
- Not enough oncologists, nurses, pathologists, physicists · The number of people with cancer is rising faster than the workforce trained to treat them.