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. 2025 Jul 7;24(1):189.
doi: 10.1186/s12904-025-01825-z.

Mapping end-of-life care in India: a scoping review to identify gaps in policy, practice, and psychosocial support

Babita P A Varkey  1 , Arun Ghoshal  2 , Naveen Salins  3 , Catriona R Mayland  4
Affiliations

Mapping end-of-life care in India: a scoping review to identify gaps in policy, practice, and psychosocial support

Babita P A Varkey et al. BMC Palliat Care. .

Abstract

Background: Little about access to palliative and end-of-life care in India is known.

Aim: To map various facets of end-of-life care in India, from perceptions of stakeholders to capacity and quality of care, training, and education, and to identify the current gaps in end-of-life care delivery.

Design: A scoping literature review was conducted, with the protocol registered on the Open Science Framework, on November 29, 2023 ( https://osf.io/twc9j ).

Data sources: Between January 1, 1990, and May 31, 2024, an electronic literature search was conducted using the MEDLINE, SCOPUS, CINAHL, EMBASE, and PSYCHINFO databases, as well as citations and grey literature.

Results: The availability and accessibility of end-of-life care are limited to a few geographical regions, primarily urban areas. While some states have community-based programs, most end-of-life care practices are concentrated in hospitals, especially intensive care units. Patients frequently lack access to essential medications, such as morphine, as well as appropriately trained medical professionals and adequate infrastructure. Financial difficulties, limited knowledge, social stigma toward the terminally ill and dying, and the psychological and physical burdens of care add to the challenges faced by stakeholders.

Conclusion: The availability and accessibility of end-of-life care in India are fragmented. A comprehensive strategy that includes policy and legislative reforms, education, and expanded palliative services is crucial for improving the quality of end-of-life care across the country.

Keywords: Caregivers; Hospice care; India; Palliative care; Terminal care.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: AG is an editorial board member for BMC PC, the rest of the authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA ScR flowchart *Consider, if feasible reporting the the number of records identified from each database or register searched (rather than the total number of across all databases/ registers) **If automation tools were used, indicate how many records were excluded by a human and how many were excluded by automation tools From: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi: 10.1136/bmj.n71
Fig. 2
Fig. 2
End of life care framework
See this image and copyright information in PMC

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