Geographic Distribution of Hospice and Palliative Medicine Specialists and Services in the Philippines

BackgroundEquitable access to palliative care remains a significant challenge in low- and middle-income countries with fragmented health systems. In the Philippines, comprehensive national data regarding the distribution of hospice and palliative medicine specialists and services remain scarce.Objective(s)This study mapped the geographic distribution of hospice and palliative medicine specialists and services in the Philippines and analyzed regional disparities in workforce density, institutional affiliations, and practice environments.MethodsA descriptive cross-sectional analysis was conducted in 2025 using purposive sampling of fellows from the Philippine Society of Hospice and Palliative Medicine. An electronic survey collected data on practice locations, institutional affiliations, and service types. Specialist-to-population ratios were calculated from Philippine Statistics Authority data, and geographic visualizations were generated in Quantum Geographic Information System and Datawrapper.ResultsFifty-four active specialists were identified nationwide, corresponding to a density of 0.05 per 100 000 population. Fifteen of 18 regions had practicing specialists; however, none were identified in Mindoro, Marinduque, Romblon, and Palawan, Bicol, or South Cotabato, Cotabato, Sultan Kudarat, Sarangani, and General Santos. Personnel and facilities were concentrated in urban centers such as the National Capital Region and Davao. Significant regional variation in care delivery was observed. While home-based care and telemedicine expanded in some areas, pediatric and rehabilitative palliative services remained inconsistent nationwide.ConclusionsGeographic imbalances persist within the Philippine palliative care workforce. Enhancing personnel distribution, decentralizing service hubs, and integrating palliative care into primary and community health frameworks are essential to achieving equitable access in underserved regions.