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Current situation, challenges and future trends of pediatric palliative care from a multi-dimensional perspective: a
Danni Lv1, Yang Li2, Xiaofei Chen3
1Department of Pediatric Oncology Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China.
Insights
Pediatric palliative care (PPC) offers comprehensive support for children with serious illnesses. Enhancing global access requires addressing workforce, medicine, and cultural barriers, integrating care early, and adapting models to local needs.
Area of Science:
- Pediatric Palliative Care (PPC)
- Global Health
- Child Health Services
Background:
- Pediatric palliative care (PPC) offers holistic support for children and adolescents with life-threatening or life-limiting conditions and their families.
- This narrative review examines PPC concepts, service models, challenges, and evidence, focusing on global disparities and the Chinese context.
Purpose of the Study:
- To summarize current pediatric palliative care (PPC) concepts and service models.
- To identify key implementation challenges and evidence in major practice areas.
- To explore global differences and future directions for PPC, including in the Chinese context.
Main Methods:
- A narrative review methodology was employed.
- A targeted PubMed search was conducted, supplemented by key consensus documents, guidelines, reviews, and organizational reports from 2010-2025.
- Findings were synthesized thematically.
Main Results:
- PPC has advanced rapidly in high-income countries, yet access is inconsistent.
- Low-resource regions face significant barriers including workforce shortages, limited essential medicines, reimbursement issues, and cultural acceptance challenges.
- Key practice areas include symptom management, psychosocial-spiritual support, family-centered decision-making, early integration, digital health, and capacity building.
Conclusions:
- Pediatric palliative care (PPC) should be integrated early into serious pediatric illness care.
- Models must be adaptable to local health systems, cultural contexts, and family needs.
- Future progress necessitates clearer definitions, robust methodologies, tiered service models, professional training, equitable access to essential medicines, context-sensitive terminology, and implementation research in underrepresented regions.
Background And Objective:
Pediatric palliative care (PPC) provides holistic support for children and adolescents with life-threatening or life-limiting conditions and their families. This narrative review summarizes PPC concepts, current service models, key implementation challenges, evidence in major practice areas, and future directions, with attention to global differences and the Chinese context.
Methods:
A narrative review was conducted using a targeted PubMed search and supplementary checking of key consensus documents, guidelines, reviews, and organizational reports published from 2010 to 2025. Findings were synthesized thematically rather than quantitatively.
Key Content And Findings:
The review is organized across four domains: foundational concepts and target populations; global service models and regional differences; major challenges involving culture, access, workforce, policy, financing, and ethics; and key practice areas including symptom management, psychosocial-spiritual support, family-centered decision-making, early integration, digital health, and capacity building. PPC has developed rapidly in high-income settings, but access remains uneven, and low-resource regions face persistent barriers related to workforce, essential medicines, reimbursement, and cultural acceptance.
Conclusions:
PPC should be integrated early into serious pediatric illness care while remaining adaptable to local health-system capacity, culture, and family needs. Future progress requires clearer definitions, stronger methods, tiered service models, professional training, equitable access to essential medicines, context-sensitive terminology, and implementation research in underrepresented regions.
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