The landscape of healthcare within Sri Lanka is undergoing a profound transformation as the Ministry of Health, in close collaboration with the World Health Organization (WHO), orchestrates a systematic expansion of palliative care services across the national health infrastructure. In a significant milestone for the island nation’s medical sector, the National Cancer Control Programme (NCCP) recently convened a comprehensive national review session to evaluate the progress and efficacy of palliative care consult services, which have now been successfully established across twenty-three tertiary and secondary level health institutions.
This strategic initiative, which was presided over by the Director General of Health Services, serves as a testament to the government’s commitment to ensuring that person-centred care is not merely a theoretical ideal but a functional reality for patients grappling with life-limiting illnesses. By examining early service data and facilitating an exchange of practical experiences between hospital teams, the review identified critical priorities for the continued integration of palliative care into the routine delivery of health services.
Institutional Progress and Growing Integration
The findings presented during the national review illustrate a remarkable trajectory of growth within the hospital network, where institutional accountability has been prioritised through the appointment of dedicated consultants. It was reported that all twenty-three participating institutions now possess a consultant in charge of palliative care services, a structural development that ensures high-level oversight and clinical excellence. Furthermore, approximately fifty per cent of these hospitals have established dedicated palliative care units or consult services, providing a physical and administrative hub for the management of complex symptoms and psychosocial needs.
A particularly encouraging metric identified during the review is the increasing integration of these services into the broader clinical environment. Approximately seventy per cent of the participating hospitals reported receiving regular referrals from other clinical units, suggesting that the medical fraternity is increasingly recognising the value of palliative interventions alongside curative treatments. This shift towards a multidisciplinary approach is essential for addressing the multifaceted challenges faced by patients, ranging from physical pain management to the spiritual and emotional distress that often accompanies chronic illness.
Extending Care Beyond Oncology
While palliative care has historically been associated predominantly with oncology, the current expansion in Sri Lanka deliberately broadens this scope to include a wider demographic of patients. The review underscored that nearly one-third of the individuals currently receiving palliative services are non-cancer patients. This diverse case mix includes those living with chronic kidney disease, chronic cardiac failure, cerebrovascular disease (stroke), chronic liver disease, chronic respiratory disease, and various neurological conditions.
The inclusion of these non-communicable diseases within the palliative care framework highlights the necessity of embedding specialised competencies across all medical specialities and levels of care. It ensures that regardless of the specific diagnosis, any patient facing a serious, life-limiting condition can receive the compassionate support required to maintain their quality of life. This broader application of palliative principles is also a key interest for the Global Sri Lankan community, many of whom maintain close ties with the healthcare needs of their relatives back home.
Community-Based Continuity of Care
One of the most significant themes of the national review was the emphasis on building a continuum of care that extends from the hospital ward directly into the community. Data indicates that approximately one-third of patients under palliative care are referred to primary medical care institutions, while a similar proportion receives home-based care. This decentralisation of services is instrumental in ensuring that patients can remain in the comfort of their own homes, surrounded by their families, while still receiving professional medical oversight.
During his keynote address, Dr Rajesh Pandav, the WHO Representative to Sri Lanka, highlighted the pivotal role played by Arogya Health Centres and Public Health Nursing Officers (PHNOs). These local health hubs and dedicated nursing staff are the backbone of the task-sharing model, which brings essential symptom management and psychosocial support closer to the community level. The proposed care pathway involves a seamless transition: starting with a referral and an individualised palliative care plan, followed by linkage through Primary Medical Care Institutions, and culminating in home-based care delivered by PHNOs in coordination with divisional secretariats and religious leaders.
International Collaboration: The COMPASS Project
The global recognition of Sri Lanka’s efforts in this field is evidenced by its selection for the Collaborative Movement for Palliative Care Access and System Strengthening (COMPASS) Project 2026–2027. Established under the Global Initiative for Childhood Cancer, this project is designed to bolster referral systems and workforce capacities across all levels of care. The COMPASS project will be particularly instrumental in improving access to essential medicines and analgesics, ensuring that even the most vulnerable patients, including children, are afforded relief from unnecessary suffering.
This international partnership aligns with the broader goals of the Global Initiative for Childhood Cancer Accelerator Grant, providing Sri Lanka with the technical and financial support necessary to refine its emerging palliative care policy. For those interested in the broader context of health and wellness within the community, such as the relationship between lifestyle and chronic disease, eLanka provides various resources including articles on dietary health and heart disease.
Future Directions and Policy Implementation
The outcomes of this national review are set to inform a comprehensive strategic action plan that will guide the phased expansion of services across the remaining districts of the country. Currently, around fifty per cent of districts have at least one hospital providing palliative care consult services, leaving a significant but clear path for future development. The upcoming policy framework will prioritise the strengthening of dedicated service spaces, the enhancement of workforce competencies, and the promotion of equitable access to pain relief.
The commitment shown by the Ministry of Health and the NCCP ensures that the Sri Lankan health system is moving towards a future where compassion and clinical excellence are inextricably linked. By mobilising social, spiritual, and philanthropic support alongside medical interventions, Sri Lanka is setting a benchmark for palliative care in the region, ensuring that patients and their caregivers are supported throughout their journey with dignity and respect.
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