Integrating palliative care into primary healthcare: assessing the impact of capacity building programs for primary health workers in a coastal region of India.

Authors

Malathi G Nayak, Radhika R Pai, Arun Ghoshal, Naveen Salins

Published in

BMC nursing. Jul 04, 2026. Epub Jul 04, 2026.

Abstract

Palliative care integration into primary healthcare is essential to improving access for patients with life‑limiting illnesses in low‑ and middle‑income countries. Frontline health workers require targeted capacity‑building to strengthen symptom management and community‑based care.
To evaluate the effectiveness of a structured capacity‑building program on the knowledge and attitudes of ASHA workers and ANMs/Staff Nurses regarding palliative care.
A quasi‑experimental design was used among 984 ASHA workers and 335 ANMs/Staff Nurses in southern India. Participants received structured training on symptom assessment, communication, and home‑based palliative care. Pre‑test and post‑test data were collected using validated knowledge and attitude scales. Data were analysed with Wilcoxon Signed‑Rank tests. The TREND (Transparent Reporting of Evaluations with Nonrandomized Designs) checklist has been completed.
ASHA workers demonstrated significant improvement in knowledge (r = .714) and attitude (r = .312) scores. Likewise, ANMs/Staff Nurses showed large gains in knowledge (r = .973) and substantial improvements in attitude (r = .682). The proportion of participants with strong knowledge increased from 9% to 35.2% among ASHAs and from 1.2% to 14% among ANMs/Staff Nurses.
Capacity‑building interventions significantly strengthen primary healthcare workers' competencies in palliative care. Integrating structured palliative care training into national primary healthcare systems enhances awareness and positive attitudes toward palliative care, thereby strengthening their preparedness to provide supportive care. Patient or Public Contribution: No Patient or Public Contribution was sought for this research.

PMID:
42401891
Bibliographic data and abstract were imported from PubMed on 05 Jul 2026.

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