The National Cancer Control Programme of the Ministry of Health, with support from WHO, convened a national review session to assess progress in expanding palliative care consult services across 23 tertiary and secondary level health institutions in Sri Lanka.
The review, presided over by the Director General of Health Services and facilitated by a review panel convened by the National Cancer Control Programme, provided an opportunity to examine early service data, share experiences from hospitals, and identify priorities for strengthening palliative care as part of an integrated health system response.
Strengthening person-centred care
Hospital teams presented practical initiatives to improve person-centred care for patients and families. These included strengthening links with primary care services, improving pain and symptom management, supporting access to medicines and analgesics at home, and mobilizing social, psychosocial, spiritual, community and philanthropic support for patients and caregivers.
Key findings from service data
The data showed encouraging progress across the hospital network. All 23 institutions reported having a consultant in charge of palliative care services. Around half of the participating hospitals had established dedicated palliative care consult services or units, while approximately 70% reported receiving referrals from other clinical units, indicating growing integration of palliative care into routine service delivery.
The findings also highlighted early progress in extending care beyond hospitals. Approximately one-third of patients under care were referred to primary medical care institutions for continuity of support, and a similar proportion received home-based care. Some patients were also referred to hospices, underscoring the importance of stronger referral and follow-up mechanisms across hospital, primary care, hospice and community settings.
Expanding access beyond cancer care
The review emphasized that palliative care needs extend beyond cancer. Nearly one-third of patients receiving services were non-cancer patients, including people living with chronic kidney disease, chronic cardiac failure, cerebrovascular disease, chronic liver disease, chronic respiratory disease, neurological conditions and other serious illnesses. This broader case mix reinforces the need to embed palliative care competencies across specialties and levels of care, so patients and families can receive appropriate support regardless of diagnosis.
The review also noted that around 50% of districts currently have at least one hospital with palliative care consult services or palliative care services. This indicates an important foundation for expansion, while also highlighting the need to strengthen dedicated service spaces, workforce capacity, referral systems and integration across tertiary, secondary and primary care.
Building continuity of care closer to communities
During his keynote address, Dr Rajesh Pandav, WHO Representative to Sri Lanka, emphasized the important role of Arogya Health Centres and Public Health Nursing Officers in bringing palliative care closer to communities and supporting task-sharing for home-based care.
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The proposed care pathway discussed during the review outlined a continuum of support: referral with an individualized palliative care plan; linkage through Primary Medical Care Institutions and Arogya Health Centres; home-based care delivered by Public Health Nursing Officers; and coordination with non-health partners, including divisional secretariats, non-profit organizations, religious leaders and volunteers.
WHO support and next steps
WHO will continue to support Sri Lanka’s efforts to improve the quality and reach of palliative care services. Sri Lanka has been selected to participate in the Collaborative Movement for Palliative Care Access and System Strengthening (COMPASS) Project 2026–2027, established under the Global Initiative for Childhood Cancer. The project is expected to support stronger palliative care services, referral systems and capacities across all levels of care, in alignment with the Global Initiative for Childhood Cancer Accelerator Grant projects.
The outcomes of the national review will inform recommendations for Sri Lanka’s emerging palliative care policy and strategic action plan. These recommendations will guide phased service expansion, strengthen community and home-based care, improve access to pain relief and essential medicines, build workforce competencies, and promote compassionate, equitable and continuous support for patients and caregivers across the health system.