Comparing the Need and Development of Pediatric Palliative Care in Mexico: A Geographical Analysis
Jorge Alberto Ramos-Guerrero1, Juan Esteban Correa-Morales2, Miguel Antonio Sánchez-Cárdenas3
1Department of Palliative and Pain Medicine, Hospital General de Occidente, Secretaría de Salud, Jalisco, Mexico.
Insights
Pediatric palliative care (PPC) in Mexico is underdeveloped, with significant regional disparities. Most states are in early development stages, failing to meet the needs of children with serious health-related suffering.
Area of Science:
- Public Health
- Pediatrics
- Palliative Care
Background:
- The Global Atlas of Palliative Care (GAPC) indicates preliminary integration of adult palliative care in Mexico.
- Existing data does not accurately reflect the development status of pediatric palliative care (PPC).
Purpose of the Study:
- To assess the current need for PPC in Mexico.
- To evaluate the developmental level of PPC services across Mexican states.
Main Methods:
- Estimated PPC need using national mortality data for conditions causing serious health-related suffering.
- Assessed PPC development using indicators for service access and opioid availability.
- Classified state-level PPC development using adapted GAPC categories.
Main Results:
- In 2021, 10,677 children died from conditions requiring PPC, indicating a need of 25/100,000 children.
- No Mexican state has achieved advanced PPC integration (Category 4a/4b).
- Most states (62.6%) are in the capacity-building phase (Category 2), with uneven distribution of services.
Conclusions:
- PPC services in Mexico are inequitably distributed, hindering access to care for children and families.
- A significant gap exists between adult palliative care development and the underdevelopment of PPC in Mexico.
- Findings highlight the urgent need for targeted interventions to advance PPC services nationwide.
Context:
The Global Atlas of Palliative Care (GAPC) ranked Mexico's palliative care services at a preliminary integration stage into mainstream healthcare services. However, this data does not reflect pediatric palliative care (PPC) development.
Objectives:
To analyze the current need and level of development of PPC within Mexico.
Methods:
PPC need was estimated using causes of death associated with serious health-related suffering from national mortality data from the General Directorate of Health Information. The level of development was measured through six indicators involving access to PPC services and opioids, then classified using the GAPC development categories adapted to regional territories based on available data.
Results:
In 2021, 37,444 children died in Mexico. Of those, 10,677 (28.29%) died from conditions with serious health-related suffering, averaging a need for PPC of 25/100,000 children. Out of Mexico's 32 states, two (6.2%) had no PPC activity (category 1), twenty (62.6%) were in a capacity-building phase (category 2), eight (25%) had isolated PPC provision (category 3a), while two (6.2%) had generalized PPC provision (category 3b). No state had early (category 4a) or advanced PPC integration (category 4b). Overall, Mexico was classified as category 2.
Conclusions:
PPC services are distributed unevenly across the country, leading to inequitable access to care and an inability to meet the needs of patients and families. There is a disparity between the level of development of adult palliative care services and the underdevelopment of PPC in Mexico. This information can help stakeholders guide the development of PPC where it is needed most.
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