Report on palliative care development in Uruguay based on the WHO indicators

Abstract

This report describes the current palliative care (PC) situation in Uruguay, highlighting the challenges the country faces in providing PC to over 17,000 Uruguayans who – according to estimates – require PC each year. Commissioned by the WHO - PAHO representation in Uruguay, the WHO Collaborating Centre ATLANTES organised a two-day workshop in Montevideo to examine and adapt the WHO PC development indicators to the Uruguayan context in collaboration with the National PC Program. WHO invited representatives from the health, education, ministries, and social organisations sectors, who worked on a data collection tool whose responses could be categorised into four levels of development: initial, intermediate, established, and advanced. The report highlights each indicator’s strengths and weaknesses and summarises the level of implementation in each area of the country. The empowerment of individuals and communities is explored through two indicators. The first reveals a strong presence of patient and family associations advocating for PC and promoting patient rights, as well as the existence of the Uruguayan Society of Medicine and Palliative Care (SUMCP). The second confirms the existence of a national policy on advance care planning (advanced level). Since 2013, there has been a National PC Plan. PC services are included in the list of health services provided by the primary level of care (with an audit mechanism carried out by the Ministry of Public Health (MSP)), and there is a national authority coordinating PC care crystallised in the National PC Program. The latter depends on and is based on the MSP. Although it has no budget, it has a growing scientific and technical structure with adequate staff (advanced level).