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Description
The project aims to ensure equal access to palliative care for beneficiaries in small rural and urban disadvantaged communities, by creating and piloting an integrated and specialized services model, in line with current legal provisions. The most important intervention of the project aims to cover the needs of patients with severe or terminal illnesses and their families, by providing complex services that are not universally accessible through the national health system: specialized medical interventions, nursing and other complex services associated with the medical act: specialized psychological assistance, social services, support for the family during the mourning period etc. The target group of the project consists of 1,500 people (adults and children with progressive chronic diseases) from 105 communities with less than 20,000 inhabitants (of which 1,200 live in rural areas). The communities are selected from 6 counties (Brașov, Alba, Giurgiu, Ilfov, Bacău and Bihor). The initiative also includes the training of 170 palliative care professionals, as well as the development of a public policy document in this field.
Summary of project results
Romania faced significant challenges in healthcare access, particularly in palliative care services. The country''s declining population, aging demographics, and lifestyle-related health issues (e.g., smoking, obesity, alcohol use) increased the demand for healthcare, especially for chronic and terminal illnesses. Rural areas, home to over 43% of the population, struggled with higher mortality rates and limited healthcare services, forcing residents to travel long distances under inadequate transportation conditions in order to get the healthcare services they need. Poverty remained a critical issue, with nearly 40% of the population at risk of poverty and social exclusion, notably in Roma communities, further limiting access to healthcare.
An assessment revealed over 172,600 people needed palliative care annually, with a high demand in rural regions. However, in 2018, there were only 13 home-based palliative care teams nationwide, with significant gaps in all targeted counties. Additionally, a discrepancy existed between the number of trained palliative care professionals and those actively working in the field. No outpatient palliative care facilities operated in the targeted counties, despite a documented need.
The "PALCommunity" project aimed to address these disparities by developing and piloting an integrated palliative care model in 105 disadvantaged rural and small urban communities across six counties and five development regions. The project focused on providing equitable access to palliative care for individuals with progressive chronic illnesses, combining social and healthcare services to reduce urban-rural inequalities.
By the project''s end, it contributed to a sustainable improvement in healthcare access for vulnerable groups, aligned with national and local development strategies. It strengthened community-based services, improved healthcare infrastructure, and enhanced the capacity of medical professionals, offering a replicable model for future initiatives.
The "PALCommunity" project aimed to improve access to palliative care for people with progressive chronic illnesses in disadvantaged rural and small urban communities across six counties and five development regions in Romania. The project addressed disparities in socio-medical services by integrating social and healthcare support to reduce urban-rural inequalities, reaching overall 289 rural and small urban communities.
Throughout the project, 1.515 unique patients benefited from specialized palliative care, receiving medical, social, and emotional support tailored to their conditions. Home visits played a crucial role in this approach, with 28.707 interventions ensuring that patients could receive high-quality care in a familiar environment. In addition, outpatient services were strengthened despite initial challenges, leading to 1.595 medical consultations that helped improve symptom management and overall well-being.
Beyond medical support, the project focused on the social and emotional aspects of palliative care. Day centers and therapeutic camps created spaces where both children and adults could find comfort, social interaction, and professional assistance, resulting in 3.962 participations in structured activities designed to enhance quality of life. To further support patients and families, a 24/7 helpline service provided more than 2.478 counseling sessions, ensuring continuous access to guidance and emotional support.
The project also focused on training and capacity building. A total of 170 professionals involved in palliative care received specialized training, while 170 stakeholders who interact with beneficiaries, such as social workers and community leaders, were informed about palliative care principles. This approach increased the competence and readiness of local service providers.
To ensure broader impact, the project promoted the integrated palliative care model to over 100 local, county, and national public institutions. Through awareness campaigns and dissemination events, the project shared best practices and encouraged the adoption of this model in other regions.
Overall, the project immediately improved access to essential palliative care services, enhanced the skills of healthcare professionals, and raised awareness among public institutions. It provided a replicable model that can contribute to sustainable healthcare development in disadvantaged communities.
The ”PALCommunity” project significantly improved access to palliative care for vulnerable individuals in rural and small urban areas. By developing and implementing an integrated care model, the project combined basic and specialized services to address the complex needs of patients with progressive chronic diseases.
The project developed a coordinated palliative care model aligned with current legal standards. It established clear protocols, service pathways, and collaboration frameworks between healthcare and social service providers. The new model was tested on 1,500 adult and child beneficiaries with chronic illnesses, providing support to 1,500 vulnerable families. Beneficiaries received home-based, outpatient, and specialized palliative care services. These activities led to immediate outcomes, such as improved quality of life for patients and enhanced support for caregivers.
Education and training were also central to the project’s success. Informational materials such as brochures and videos were developed to empower caregivers and patients with essential knowledge about palliative care. Additionally, training sessions for local medical professionals and social workers strengthened community-based support, fostering long-term sustainability.
The project’s long-term impact extends beyond its direct beneficiaries. By establishing structured palliative care services and facilitating collaboration between professionals, the initiative laid the groundwork for sustainable, community-integrated care models that can be replicated at the national level. Through advocacy and policy recommendations, the project has also contributed to shaping a more comprehensive approach to palliative care within the public health system.
Ultimately, by addressing both medical and social needs, "PALCommunity" has improved the quality of life for patients and their families while strengthening the capacity of local communities to offer ongoing support.