Policy expertise

Developing Palliative Care Services in Serbia

Policy Area
Country/Region
Serbia
Funder
European Commission (EC)
Duration
2011 - 2014
OPM contact

This three year project has supported the government of Serbia to deliver a comprehensive system of effective palliative care across Serbia. Previously non-existent in the country, palliative care became a key focus of recent government health reforms that recognised the need to embed holistic care within the country’s health and social care systems. We provided technical assistance to the Ministry of Health and other key stakeholders to deliver the National Strategy for Palliative Care and associated Action Plan. By promoting a participatory approach to support the development of academic courses and materials, training programmes, policies and best practice guidelines, this project has helped ensure the sustainability of high quality palliative care delivery across Serbia. Key outcomes include establishment of the first accredited palliative care course for social workers in Europe and the inclusion of palliative care into the curriculum of medical schools across Serbia.

Healthcare in Serbia is changing rapidly in response to a growing recognition of the need to integrate palliative care at all levels of service provision. In 2011, following the same criteria used to rank the development of palliative care across the European Union, Serbia ranked alongside the lowest scoring EU member (Estonia).

Healthcare reforms were introduced in 2002 and accelerated in 2005 with the adoption of the Law on Health Insurance and the Law on Health Care. In 2009, the Ministry of Health (MoH) published a National Strategy for Palliative Care.

This project was established to operationalise the Action Plan and support the development of a comprehensive and inclusive system of palliative care in Serbia.

 

We worked with a number of local and international partners to support the implementation of a detailed work plan in line with the National Strategy for Palliative Care.

The work plan was delivered in close collaboration with a wide range of stakeholders including officials from the Ministry of Health and Ministry of Labour and Social Affairs, hospitals, NGOs, Dom Zdravljas (health centres) and academic institutions to encourage knowledge-sharing and optimise Serbian input and ownership of the project. Project outcomes were communicated through a number of different channels to improve public awareness of, and community involvement in, palliative care.

Specific areas of technical assistance and advice included:

  • Development of a model of palliative care provision for Serbia, including best practice guidelines, policy, standards and quality indicators
  • Development of a legislative framework to support the integration of palliative care into Serbian law
  • Design and delivery of Continuing Medical Education (CME) courses across all levels and in specialist areas including children’s palliative care
  • Development of comprehensive palliative care curricula for undergraduate medical courses and accompanying course material
  • Support for the establishment of Palliative Care Units (PCUs) in hospitals and healthcare centres
  • On-site mentoring for healthcare staff in PCUs
  • District-level forums to identify potential for local-level Palliative Care Coordinating Bodies (PCCBs)

Building the capacity of existing healthcare staff was a key overarching focus of the project cutting across all areas of work. Capacity building activities included both instructive and clinical education programmes using technology and resources that are appropriate to the local setting.

 

This project has achieved significant results. Palliative care has been incorporated into the curriculum of all the medical schools in Serbia and is now a medical speciality in the country. Over 1,830 healthcare professionals have taken part in palliative care training courses and mentoring programmes and the first palliative care handbook has been published in the country.

Serbia has also become the first country in Europe to accredit a palliative care course for social workers as a direct result of this project. PCUs are operational in 15 sites across the country.

More widely, this project has supported the development of a national model of palliative care delivery that is being rolled-out across the country and incorporates robust quality indicators, standards of care and best practice guidelines. Underlying this model is the principal that palliative care should be accessible to everyone as a basic human right.

 

Portfolio Manager, Social Care Services