Global palliative care development - 0990069

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  • Department: Hull York Medical School
  • Credit value: 20 credits
  • Credit level: M
  • Academic year of delivery: 2024-25

Module will run

Occurrence Teaching period
A Spring Term 2024-25

Module aims

The aim of this module is to introduce students to key policy and systems issues surrounding the unequal development and implementation of palliative care globally including pain management services worldwide. The module will enhance understanding and capacity on global palliative care by providing theoretical and practical knowledge and skills to explore, assess and identify key global issues surrounding global palliative care using evidence-based techniques. This process will be informed by an expert knowledge base of existing evidence, available global datasets and practical experiences applying implementation frameworks to generate palliative care research questions and evaluate policy and programme implementation on global palliative care and access to pain management services. Key debates relevant to palliative care development in the broader context of international development will be introduced and applied to palliative care, particularly in relation to ‘framing’ as a key theory of policy development.

Module learning outcomes

By the end of this module, students will be able to:

  • Critically appraise the global development of palliative care in context of global regulations, resolutions, laws and human rights perspectives.

  • Critically assess opportunities for ‘policy transfer,’ processes of adaptation of interventions to different cultural contexts.

  • Apply evidence of the ‘broad benefits’ of palliative care to use different ‘frames’ to advocate for palliative care to different health actors

  • Apply implementation science frameworks to identify priority issues for palliative care development in different income-settings and develop research questions

Module content

  • Session 1. Introduction to global palliative care – concepts, definitions and overview of the global situation (inequities and policies)

  • Session 2. Narratives of international palliative care development – history, community action (bottom up), policy led (top down) and international lesson learning, influence of global policies, use of global datasets to develop research questions

  • Session 3. ‘Framing’ palliative care for global advocacy – what evidence is there of broad benefits and what more is needed?

  • Session 4. Models of palliative care in different income settings – a focus on the Neighbourhood Network in Palliative Care (Kerala, India) and Hospice Uganda (Uganda) - community participation, volunteers and informal carers

  • Session 5. Student group presentations and discussion

  • Session 6. Access to controlled medicines – implementation of the Single Convention on Narcotics (a problem of implementation or of policy?)

  • Session 7. Using implementation frameworks to: identify evidence gaps and determine priorities.

  • Session 8. Reflection and planning (summing up, bringing everything together)

  • Session 9. One-to-one tutorials

Sessions will be recorded with students expected to provide key reflections and take away messages after each recorded session via the discussion broad which will be monitored and facilitated by tutors. Guest lecturers will be invited to share their experience/work in global palliative health issues in diverse settings. Examples will be drawn upon from different low and middle-income countries facing distinct challenges or overcoming barriers to service to increase access to palliative care as well as wider global palliative care literature and global social policy theory. Multidisciplinary tutors will help signpost relevance and potential transferability of principles and practices between one setting and another to students. Students work on group work/assignments to enable them to develop practical skills in addressing key issues in global palliative care. Students will undertake a written assignment applying implementation framework techniques to build on knowledge gained and tailor it to their palliative care interest or setting.

Group discussions, guest lecturers, online tasks, assignments and tutor interactions allow students to build on the content delivered and tailor it for their own key interest and/or work setting. Examples will be drawn upon from different low and middle-income countries facing distinct challenges or overcoming barriers to service to increase access to palliative care as well as wider global palliative care literature and global social policy theory. Multidisciplinary tutors will help signpost relevance and potential transferability of principles and practices between one setting and another to students

Indicative assessment

Task % of module mark
Essay/coursework 100

Special assessment rules

None

Indicative reassessment

None

Module feedback

  • Written feedback on on-line tasks via peer and tutor responses

  • Verbal feedback on group work presentation

  • One-to-one sessions prior to essay submission Written feedback (marking rubric) on individual essay post-submission

Indicative reading

Brakema EA, van der Kleij RMJJ, Poot CC et al. Mapping low-resource contexts to prepare for lung health interventions in four countries (FRESH AIR): a mixed-method study. Lancet Glob Health, 2022 10(1):e63-276.

Clark J, Barnes A, Campbell M and Gardiner C. A Life or “Good Death” Situation? A Worldwide Ecological Study of the National Contexts of Countries That Have and Have Not Implemented Palliative Care. J Pain and Symptom Manage, 2019;57(4):793-801.

Clark J, Barnes A, Gardiner C. Reframing Global Palliative Care Advocacy for the Sustainable Development Goal Era: A Qualitative Study of the Views of International Palliative Care Experts. J Pain Symptom Manage. 2018; 56: 363–370. pmid:29953941

Knaul FM, Farmer PE, Krakauer EL, De Lima L, Bhadelia A, Kwete XJ et al. Alleviating the access abyss in palliative care and pain relief-an imperative of universal health coverage: The Lancet Commission report ,2018; 391: 1391–1454. pmid:29032993.

Kumar SK. Kerala, India: A Regional Community-Based Palliative Care Model. J of Pain and Symptom Manage, 2007;33(5):623-627.

Means, A.R., Kemp CG, Gwati-Chore MC et al. Evaluating and optimizing the consolidated framework for implementation research (CFIR) for LMICs: a systematic review. Implementation Sci, 2020;15:17. https://doi.org/10.1186/s13012-020-0977-0.

Namisango E, Allsop MJ, Powell RA, et al. Investigation of the Practices, Legislation, Supply Chain, and Regulation of Opioids for Clinical Pain Management in Southern Africa: A Multi-sectoral, Cross-National, Mixed Methods Study. J Pain Symptom Manage, 2018;55(3):851-863. doi: 10.1016/j.jpainsymman.2017.11.010.

Sallnow L, Smith R, Ahmedzai SH et al. Report of the Lancet Commission on the Value of Death: bringing death back into life. Lancet, 2022;399(10327):837-884. DOI:https://doi.org/10.1016/S0140-6736(21)02314-X