NATIONAL PROGRAM FOR PALLIATIVE CARE

The National Program for Palliative Care (NPPC) aims to provide palliative care services to patients suffering from cancer and other diseases for pain relief and symptom control, minimizing their sufferings.

The NPPC program was launched in 2014 in Maharashtra. As of now, the program is being implemented in 17 districts of Maharashtra. Under NPPC, 159 Primary Health Centers (PHCs) and a population of 43,59,027 are covered for palliative services in these districts.

The program provides funds for human resources, drugs, and capacity building of staff to deliver palliative services to patients. From 2014 to March 2018, a total of 27,755 new patients have been provided OPD, IPD, and home visit services.

Special pilot programs for palliative care are running on a Public-Private Partnership (PPP) mode at Jawhar and Igatpuri blocks in Palghar and Nashik districts, respectively. In this project, ASHA workers are involved in identifying and following up with beneficiaries. From 2011 to 2018, ASHAs have identified new patients and provided follow-up care. Capacity building of medical staff is conducted at the State Palliative Care Center in Mumbai.

The program was expanded to 8 districts of Maharashtra in 2021-22: Aurangabad, Ahmednagar, Nagpur, Jalgaon, Beed, Hingoli, Latur, and Thane. In 2022-23, it was further expanded to 11 districts: Akola, Buldhana, Yavatmal, Kolhapur, Sangli, Raigad, Gondia, Dhule, Solapur, Mumbai, and Mumbai Suburban.

Districts Under Palliative Care Program

Srno	Name Of Districts Sanctioned Year 2013-14	Sr no	Name Of Districts Sanctioned Year 2018-2019	Sr no	Name Of Districts Sanctioned Year 2021-2022	Sr no	Name Of Districts Sanctioned Year 2022-2023
1	Nashik (Igatpuri)	11	Pune	18	Aurangabad	26	Akola
2	Palghar (Javhar)	12	Osmanabad	19	Ahmednagar	27	Buldhana
3	Bhandara	13	Parbhani	20	Nagpur	28	Yavatmal
4	Chandrapur	14	Sindhudurg	21	Jalgaon	29	Kolhapur
5	Gadchiroli	15	Nanded	22	Beed	30	Sangli
6	Wardha	16	Jalna	23	Hingoli	31	Raigad
7	Washim	17	Ratnagiri	24	Latur	32	Gondia
8	Nandurbar			25	Thane	33	Dhule
9	Satara					34	Solapur
10	Amravati					35	Mumbai
						36	Mumbai Suburban

Provide Palliative Service

• OPD and IPD services at district hospitals, with dedicated OPD days twice a week.
• Provision of outreach services at CHC/PHC/HWCS by the Palliative Care team and trained staff at fixed intervals for patients admitted to CHC/PHC.
• Home-based services and visits conducted by HWC staff.
• Establishment of referral linkages for comprehensive care.

Diseases Covered

• Malignancy
• HIV/AIDS
• Paralysis: stroke, hemiplegia, paraplegia, quadriplegia
• Adult Neurological Disorders: Dementia, Alzheimer’s, Parkinson’s, chronic psychiatric disorders
• Pediatric Neurological Disorders: mental retardation, cerebral palsy (C.P.)
• Epilepsy
• MDR complicated TB
• Hematological Disorders: Thalassemia, chronic sickle cell
• Complicated Leprosy
• Metabolic Disorders
• Severe congenital anomalies

NPPC- District level Sanction Post

Sr. No.	Districts	Medical Officer/ Physician – Sanction	Medical Officer/ Physician – Filled	Medical Officer/ Physician – Vacant	Nurse/GNM – Sanction	Nurse/GNM – Filled	Nurse/GNM – Vacant	Multi task worker/social worker – Sanction	Multi task worker/social worker – Filled	Multi task worker/social worker – Vacant
Total	Total	34	10	24	86	42	40	34	8	26

Physical performance

Sr. No.	Health Professionals	Total no. in the district (Dec. 2024)
1.	Total no. of new patients seen in the OPD	56186
2.	Total No of patients admitted in IPD	19081
3.	Total no. of follow-up cases seen in the OPD	25858
4.	Total no of new patients seen in the home based care	3722
5.	Total no of follow-up cases seen in the home based care	14612

NPPC Financial Details

Sr. No	Year	PIP	Expenditure	%
1	2022-23	63.47	12.31	19.39
2	2023-24	62.02	29.17	47.04
3	2024-25	33.65	7.26	21.57

Beneficiary:

Patients suffering from: Cancer HIV/AIDS Neurological disorders (e.g., Dementia, Alzheimer’s, Parkinson’s) Chronic psychiatric disorders Pediatric neurological disorders (e.g., cerebral palsy, mental retardation) Chronic conditions like Thalassemia, Sickle Cell, and complications from TB or Leprosy

Benefits:

OPD and IPD services in district hospitals (dedicated OPD days twice a week) Outreach services at CHC/PHC/HWCs by trained staff Home-based services and visits by healthcare workers Referral linkages for comprehensive care