The Maharashtra health department will roll out a comprehensive palliative care programme across all state-run hospitals. With this expansion, the government aims to provide structured, accessible, and compassionate care to patients suffering from life-limiting and chronic illnesses.
Home-Based Services Expanded Beyond Cancer Care
Previously, Maharashtra offered home-based palliative care services primarily to cancer patients and only in select districts. However, under the new initiative, the state will extend these services across all districts and broaden eligibility.
Now, patients suffering from chronic pain due to heart, liver, kidney, or lung failure, stroke, Parkinson’s disease, dementia, childhood life-limiting conditions, and disabilities will also receive home-based support.
Strengthening the National Programme for Palliative Care
Maharashtra introduced the National Programme for Palliative Care (NPPC) in 2014 in line with guidelines issued by the Union Health Ministry. Since then, several states and union territories have adopted structured home-based palliative care services.
Building on these guidelines, the Maharashtra government has now issued a Government Resolution (GR) to implement universal palliative care services across the state.
Rising Burden of Chronic Diseases
Public Health and Family Welfare Minister Prakash Abitkar highlighted the growing burden of cancer, heart disease, diabetes, neurological disorders, respiratory illnesses, and age-related diseases in the state.
He explained that many patients require long-term treatment and continuous care. Therefore, the programme aims to ensure physical pain relief, psychosocial support, family counselling, and home-based services to provide dignified end-of-life care.
Door-to-Door Survey to Identify Beneficiaries
To implement the programme effectively, the health department will first conduct a door-to-door survey to identify patients requiring palliative care.
Umesh Shirodkar, Joint Director of Health Services, Maharashtra, stated that ASHA workers will conduct the survey. Subsequently, community health officers—either BAMS doctors or trained nurses—will provide services at the health centre level.
Additionally, Auxiliary Nurse Midwives (ANMs) and Chief Medical Officers will conduct home visits as needed. The state will follow eligibility criteria defined under central government guidelines. Importantly, the programme will provide services completely free of cost.
The identification survey will conclude by February 21, after which the universal palliative care programme will become operational statewide.
Multi-Level Care Delivery System
For preliminary palliative care, trained healthcare providers will offer counselling, physiotherapy, and symptom management at primary health centres, urban health centres, and health extension centres.
If patients require more advanced care, doctors will refer them to sub-district, district, or rural hospitals. District hospitals will reserve four to six beds specifically for palliative care. These facilities will provide 24-hour nursing care, counselling, physiotherapy, and essential medicines.
Moreover, healthcare teams will initiate home visits for patients who cannot travel to health facilities.
Improved Access to Essential Pain Medication
In a significant move, the state will now make strong pain relievers such as morphine available at primary health centres. Earlier, patients could access these medicines only at district hospitals. Trained medical officers will prescribe these medications.
Furthermore, healthcare providers will initiate palliative care services from the moment doctors diagnose a specific disease and continue them throughout the treatment journey.
Learning from National and State Models
According to the National Health Mission website, the Government of India’s expert group on palliative care recommended a national programme in its 2012 report titled “Proposal of Strategies for Palliative Care in India.”
Kerala became the first state to introduce a dedicated state-level palliative care policy, with a strong emphasis on home-based services. Subsequently, states such as Tamil Nadu, Telangana, Karnataka, Lakshadweep, Rajasthan, Assam, and Delhi NCR have also implemented home-based palliative care models.
Ensuring Dignified and Compassionate Care
Through this expanded initiative, Maharashtra aims to ensure that patients living with serious illnesses receive comprehensive, compassionate, and dignified care. By integrating home-based services, strengthening primary care infrastructure, and ensuring access to essential medications, the state is taking a significant step toward universal palliative care coverage.