National programme for Palliative Care (NPPC)

Palliative care aims to prevent and relieve health related suffering of adults, children and their families facing problems associated with life-threatening illness. It is based on a comprehensive and person-centred approach, addressing physical, psychological, social and spiritual suffering, right from detection of disease till end of life and post death in terms of bereavement support.

The National Programme for Palliative Care (NPPC) aims to provide accessible, quality palliative care to patients with terminal illnesses like cancer and AIDS. It integrates multidisciplinary support, including pain management and psychosocial care, into all healthcare levels. Under the National Health Mission, NPPC emphasizes community-based approaches, capacity building, regulatory reform for opioid access, and public awareness to improve end-of-life care.

Under the leadership of Hon’ble Health Minister Shri Viswajit Rane, Goa has emerged as a model state in providing comprehensive palliative care to its citizens.The state’s palliative care network, spanning across all healthcare levels, has been instrumental in ensuring that patients with life-limiting illnesses receive compassionate and supportive care.

Palliative Care Initiative in Goa :

A palliative care initiative  was started in collaboration with the efforts of the Non Communicable Disease Cell, Directorate of Health Services , Government of Goa and Cipla Foundation and Novi Survat.

At the heart of this network is the South Goa District Hospital’s palliative care unit, led by Dr. Ira Almeida, Project Director for the Integrated Palliative Project at South Goa District Hospital in Margao. The unit has been instrumental in providing a wide range of services, including pain management, symptom control, physiotherapy, and emotional support for adult patients. Home based Palliative care is an integral part of this program.These services are provided by the District hospital and extended further to the CHO –Sn at AAM center level.

Dr. Philomena D’Souza, Director of Novi Survat, has played a pivotal role in advancing pediatric palliative care, ensuring that young patients receive dedicated care and comprehensive support. Under her leadership, Novi Survat has made remarkable progress in providing specialized services for children and their families. These essential pediatric palliative care services have also been extended to the South Goa District Hospital in Margao, where Dr. Philomena and her team continue to provide compassionate care to pediatric patients.

Through partnerships with local organizations, the network has been able to offer comprehensive care to young patients, including pain management, symptom control, and emotional support.

Current Palliative Care Service delivery structure at Goa:

1. OPD
2. IPD
3. Home based palliative care.

The above services being provided for Adult as well as Paediatric patients

4. End Of Life Care
5. Pain management using Narcotic drugs
6. Counselling services
7. Nutrition and dietary counselling
8. Physiotherapy and Occupational therapy
9. Support Group
10. Group Therapies
11. Compassionate communities with Panchayats

Additional activities:

• Happy Hour- Patients undergoing dialysis at district hospital are given physiotherapy so as to prevent odema post  dialysis and dental checkup as such patients are more prone to dental caries.
• The session begins with a mindfulness exercise, followed by diet counseling, a dental examination, and fine motor exercises.

 Outreach Activities

1.   Visits to old age homes 
2.   AmiAsat –Compassionate Communities programme.
   • Started in October 2023, currently with 10 Panchayats groups wherein the local Panchayats are involved in identifying patients in need of palliative care in their area.
   • These patients are then referred to the team at South Goa District Hospital where the home based team then provides palliative care services. These Panchayats also provide mobility support to the team during the home visits.

3.  Movement, Music and Art therapy

4.EOLC centers :Piloted at 5 Peripheral health facilities , space at existing health facilities converted into End Of Life Care units where terminally ill patients are admitted.

5.Palliative care for Lymphatic Filariasis (LF) patients is provided through the NVBDCP and Ayushman Bharat-AAM. Community Health Officers and Multipurpose Health Workers conduct home visits to manage swelling, pain, and infections, while offering psychological support and hygiene education, ensuring improved quality of life.

6.The Stroke Rehab Clinic under palliative care offers a tailored service package to address low motivation in patients. The package includes physiotherapy, speech therapy, dietary advice, and occupational therapy, providing comprehensive support to improve recovery and quality of life.

7.Pulmonary rehabilitation 

5. Support Groups:

• Xec Xec (Cancer Support Group)

• Meetings every second Tuesday 10am – 12pm
  • Titlee(Breast Cancer Support Group)
    • Meetings every first Tuesday 10am – 12pm

• • De-Grief(Bereavement Support Group)
    • Meetings every Friday 10am – 12pm

Total Patients seen since initiation at DH (2nd January 2023 till May 2025):

Goa is also the 5th State to have developed a Goa State Palliative

Goa State Palliative Care Policy.pdf

• Medical Officer
• Staff Nurse
• Naturopathy Physician
• Physiotherapist

The training on Palliative care of the Medical Officers and Staff Nurse of both District Hospitals and peripheral health facilities was conducted at 10 day Foundation course on Palliative Care in collaboration with NGO Dilasa.  

A total of 96 OPD patients were seen in the Palliative Care OPD from August 2019 to June 2020. Home visits conducted were 23. In addition, counseling of the patients is done on nutrition and bereavement counseling. Medications such as analgesics, fentanyl patches etc. are available in the Palliative Care OPD.