Where are the values in evaluating palliative care? Learning from community-based palliative care provision

Area of Science:

• Global Health
• Public Health
• Palliative Care Research

Background:

• The 2018 Astana Declaration emphasizes primary healthcare for universal health coverage.
• Sustainable community palliative care models are a global health priority.
• Evaluating these models presents significant methodological and conceptual challenges.

Purpose of the Study:

• To explore evaluation challenges in community-based palliative care.
• To examine an existing program in Kerala, India.

Main Methods:

• An illuminative case study approach was employed.
• Rapid evaluation methodology utilized qualitative interviews, documentary analysis, and observations.
• The evaluation focused on complex interventions, axiological orientations, and postcolonial contexts.

Main Results:

• Key values identified were heterogeneity, voice, and decentralization in care.
• Outcomes were categorized into first- (individuals/organizations), second- (unintended targets), and third-order effects (indirect/distal impacts).

Conclusions:

• Successful evaluation of community palliative care is achievable.
• Attending to community care values is crucial for effective evaluation in complex settings.