Implementing Pediatric Palliative Care in Vietnam: Initial Experiences and Lessons

Area of Science:

• Pediatric Palliative Care
• Global Health
• Health Services Research

Background:

• Significant unmet need for pediatric palliative care (PPC) exists globally, particularly in low- and middle-income countries (LMICs).
• Vietnam, an emerging economy, has a nascent palliative care landscape, highlighting the need for foundational PPC services.
• The establishment of a PPC program in 2017 at a major Vietnamese children's hospital aimed to address this gap.

Purpose of the Study:

• To document the development and operational framework of Vietnam's first PPC program.
• To evaluate the initial scope of services and patient outcomes within this pioneering program.
• To offer insights for the establishment of similar programs in other LMICs.

Main Methods:

• Retrospective cross-sectional study design analyzing patients seen by the PPC inpatient consult service over 18 months.
• Descriptive statistical analysis of patient demographics, clinical profiles, and end-of-life outcomes.
• Inclusion of all patients aged 0-15.6 years referred to the PPC service.

Main Results:

• 169 children received PPC consultations, with common diagnoses including cancer, traumatic injury, and congenital syndromes.
• Psychosocial support was the primary intervention (70%), followed by pain management (28%).
• Notably, no cancer patients in the study died during hospitalization.

Conclusions:

• The PPC program achieved high utilization and volume through strategic partnerships, staff education, and cultural adaptation.
• Early findings suggest potential reductions in end-of-life interventions like chemotherapy and CPR.
• The program's experiences provide valuable lessons for developing new PPC initiatives in resource-limited settings.