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‘COVID-19 and palliative medicine: faith-based hospitals in India’
  1. Jenifer Jeba Sundararaj1,
  2. Daniel Munday2,
  3. Savita Duomai3,
  4. Priya John4,
  5. Ruby Angeline Priscilla S5,
  6. Ruth Powys6,
  7. Ashita Singh7,
  8. Kirsty J Boyd8,
  9. Liz Grant9 and
  10. Scott A Murray10
  1. 1Palliative care Unit, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  2. 2Honorary Senior Clinical Lecturer, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
  3. 3EHA, Emmanuel Hospital Association, New Delhi, India
  4. 4General Secretary, Christian Medical Association Of India, Janakpuri, Delhi, India
  5. 5Family Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
  6. 6Head of Palliative Care Services, Green Pastures Hospital, Pokhara, Nepal
  7. 7Physician, Chinchpada Christian Hospital, Chinchpada, Maharashtra, India
  8. 8Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
  9. 9Programme Director Global Health: Non Communicable Diseases, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
  10. 10Centre for Population Health Sciences, Primary Palliative Care Research Group, The University of Edinburgh, Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
  1. Correspondence to Dr Jenifer Jeba Sundararaj, Palliative care Unit, Christian Medical College and Hospital, Vellore 632004, Tamil Nadu, India; jenifermugesh{at}yahoo.com

Abstract

Objectives Faith-based organisations (FBOs) in India provide health services particularly to marginalised communities. We studied their preparedness and delivery of palliative care during COVID-19 as part of a mixed-method study. We present the results of an online questionnaire.

Methods All FBOs providing palliative care in India were invited to complete an online questionnaire. Descriptive analysis was undertaken.

Results Response rate was 46/64 (72%); 44 provided palliative care; 30/44 (68%) were in rural or semiurban areas with 10–2700 beds. Fifty-two per cent (23/44) had dedicated palliative care teams and 30/44 (68%) provided it as part of general services; 17/44 (39%) provided both. 29/44 (66%) provided palliative care for cancer patients; 17/44 (34%) reported that this was more than half their workload.

The pandemic led to reduced clinical work: hospital 36/44 (82%) and community 40/44 (91%); with reduction in hospital income for 41/44 (93%). 18/44 (44%) were designated government COVID-19 centres; 11/40 (32%) had admitted between 1 and 2230 COVID-19 patients.

COVID-19 brought challenges: 14/44 (32%) lacked personal protective equipment; 21/44 (48%) had reduced hospital supplies and 19/44 (43%) lacked key medications including morphine. 29/44 (66%) reported reduction in palliative care work; 7/44 (16%) had stopped altogether. Twenty-three per cent (10/44) reported redeployment of palliative care teams to other work. For those providing, palliative care 32/37 (86%) was principally for non-COVID patients; 13/37 (35%) cared for COVID-19 patients. Service adaptations included: teleconsultation, triaged home visits, medication delivery at home and food supply.

Conclusions FBOs in India providing palliative care had continued to do so despite multiple challenges. Services were adapted to enable ongoing patient care. Further research is exploring the effects of COVID-19 in greater depth.

  • COVID-19
  • home care
  • hospital care

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bmjspcare-2021-002924

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    Footnotes

    • Twitter @JeniferJeba

    • Contributors JJS, DM, SD, PJ, RAPS, RP, AS, KJB, LG and SAM were involved in the initial planning and design of the study. JJS, RAPS, PJ, SD and AS were involved in the conduct of the study. JJS, DM and SAM were involved in the initial draft of the manuscript. SD, PJ, RAPS, AS, KJB and LG reviewed the manuscript and provided valuable input in the finalisation of the manuscript. JJS is responsible for the overall content and will act as the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.