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Description
The National Health Development Plan 2021 - 2027 states that insufficient palliative care services are provided. The new Law on Health Care is in force from 1 April 2023. and it is the fundamental law that defines the activity of palliative care. However, the Law states only basic guidelines, and there is no special strategic document with more detail organization and development of palliative care. The palliative care system is developing unevenly.
In this period after the adoption of the new Act, it is important to point out the missing capacities and the importance of the development of comprehensive palliative care (in which the role of volunteers is significant) in order to inform both professionals and the general public and encourage them to act. Ministry of Health is preparing health care reform, therefore a stronger indication of the needs in the palliative care system would contribute to the adoption of more effective solutions that would lead to more accessible and comprehensive palliative care.
Research will be conducted of palliative care resources by county in order to obtain a comprehensive overview, which will strengthen advocacy power of the La Verna (and other associations) for public advocacy based on evidence in order to direct the reform of the health system to the field of palliative care which is the main goal of the project.
Based on the results of the research, an overview of the situation and suggestions for improvement will be prepared, as well as a policy brief on volunteers in palliative care, which will be sent to the addresses of the Ministry of Health, the Ombudsman and county offices with the aim of achieving the effect of encouraging public policy makers to be more focused to the field of palliative care.
Public advocacy activities and dissemination of results will improve the public awareness of 100,000 citizens of the Republic of Croatia about the importance of palliative care and the role and importance of volunteers.
Summary of project results
Inadequate Palliative Care: According to the National Program for the Development of Palliative Care in Croatia (2017-2020), palliative care is needed for 50-89% of all terminally ill patients, which translates to between 4,200 and 7,500 patients in the city of Zagreb alone. Additionally, around 30% of people die at home, with an estimated 1,200 to 2,200 palliative patients dying at home in Zagreb. However, the necessary services, particularly at the primary level, are insufficient.
Lack of Psychological and Community Services: The National Health Plan for the period 2021-2027 highlights a shortage of both palliative and psychological services, as well as a lack of community-based care.
Legal and Organizational Gaps: The new Health Care Act, implemented in April 2023, only defines basic elements of palliative care, such as the role of palliative care coordinators, mobile teams, and hospices. However, a comprehensive strategic document dedicated solely to palliative care has not been adopted, leaving significant gaps in the development of the system. This results in uneven access and quality of palliative care across the country.
Uneven Development Across Regions: There is a lack of uniformity in how palliative care teams, coordinators, and volunteers are organized and integrated across Croatia. Furthermore, there is no comprehensive overview of the system’s development, especially concerning the involvement of volunteers, which are essential to providing complete palliative care.
Insufficient Public Awareness and Advocacy: While organizations like La Verna focus on direct care for patients, there is insufficient time and effort dedicated to public advocacy and communication. This results in suboptimal representation of palliative patients’ needs in society, leading to a lack of public awareness and support for necessary changes in the system.
The project aimed to address these gaps by raising public awareness of the importance of palliative care, the role of volunteers, and the need for comprehensive reform to improve access to and quality of care for terminally ill patients.
The project aimed to strengthen the advocacy position of the La Verna association and the role of volunteers in palliative care. Here are the main activities and outputs:
Research and Data Collection:
- An in-depth study was conducted to gather data on palliative care resources across Croatia’s counties, including information on volunteer involvement. This was the first time such data had been systematically collected. The research highlighted the lack of resources and uneven development of palliative care across the regions, providing strong evidence for advocating improvements to the system.
Advocacy and Proposals for System Improvement:
- The gathered data served as a foundation for advocacy efforts. The findings clearly demonstrated the need for improvement in the distribution of resources and the development of palliative care, which was used to make proposals for enhancing the system. These proposals were directed to relevant institutions, including the Ministry of Health, Ministry of Labor, Pension System, Family and Social Policy, the Ombudsman’s office, and regional offices.
Public Engagement and Awareness:
- The project successfully organized a roundtable attended by various stakeholders in palliative care, both from Zagreb and other parts of Croatia. The event received significant media coverage, helping to raise awareness among the general and professional public about the research results.
- A World Hospice and Palliative Care Day event was held, which saw strong participation from collaborators and media coverage. This contributed to increasing public awareness of the importance of palliative care and the role of volunteers.
Improved Collaboration and Volunteer Integration:
- As a result of the project, the professional public became more aware of the importance of volunteers in palliative care. The visibility of the La Verna association increased, and there was a noticeable rise in the willingness of mobile palliative care teams to include volunteers in their support efforts. La Verna also received more calls for collaboration, marking a growing integration into joint care initiatives.
In summary, the project successfully advanced the understanding of palliative care needs, highlighted the importance of volunteers, and strengthened La Verna''s role in advocating for system improvements.
The project achieved several significant results and impacts for various beneficiaries, primarily professionals and organizations involved in palliative care, as well as the general public. Here’s a breakdown of the outcomes:
Increased Collaboration and Engagement:
- Key collaborators such as mobile health teams, elderly care homes, students, and hospitals were actively involved in the project activities. They participated in the "ZaČin ljubavi" action, which marked World Hospice and Palliative Care Day. They worked alongside La Verna volunteers at information booths, where they had the opportunity to engage with interested citizens, raising awareness and sharing knowledge about palliative care.
- These collaborators were also invited to participate in a roundtable discussion on “Good Palliative Care. Volunteers – Balm and Strength,” held for World Volunteer Day. The roundtable saw active participation from 39 individuals who contributed to discussions and proposed suggestions for improving the palliative care system. These proposals were then submitted to policymakers and publicly shared through media outlets.
Improved Professional Readiness to Collaborate:
- One of the key outcomes was the increased readiness of health professionals and mobile palliative care teams to collaborate with volunteers and the La Verna association. This shift in attitude contributes to better care for patients and their families, fostering a more integrated approach to palliative care.
Unexpected Positive Outcome:
- An unexpected but highly impactful result was an invitation from the President of Croatia, Zoran Milanović, to meet with the La Verna association. This meeting provided an opportunity to discuss the state and shortcomings of the palliative care system in Croatia and the activities La Verna is involved in. The meeting was media-covered, significantly boosting the visibility of La Verna’s work and palliative care issues in Croatia.
Beneficiaries:
- Mobile Health Teams and Elderly Care Homes: These organizations became more engaged in the importance of volunteer involvement in palliative care.
- Students and Medical Schools: Students had the chance to directly interact with professionals and volunteers, enhancing their understanding of palliative care.
- Healthcare Professionals: They experienced an increased willingness to collaborate with volunteers, improving patient care and professional networks.
- General Public: The broader public gained awareness of palliative care through media coverage and public events.
- La Verna: The association itself gained visibility and support for its advocacy efforts, culminating in recognition at the national level.
Overall, the project successfully contributed to the integration of volunteers in palliative care, raised public and professional awareness, and influenced policy discussions, benefiting both palliative care providers and recipients.