Bringing Bedside Support to the Margins: A Community-Led Model for Equitable Palliative and Supportive Care in Rural India
1
Oncology, MAS Clinic & Hospital, Tamluk, India
Popul. Med. 2026;8(Supplement Supplement 1):A1195
ABSTRACT
BACKGROUND:
Rural communities in India face persistent inequities in access to palliative care, bedside support, and psychosocial services, especially among cancer patients and their families. Geographic isolation, poverty, lack of trained providers, and sociocultural stigma contribute to late presentation, unmanaged symptoms, and limited end-of-life support. To address these gaps, a community-driven bedside support model was implemented in East Medinipur District, West Bengal, integrating oncology social work, home-based palliative care, and patient advocacy.
METHODS:
A longitudinal community program (2005–2025) was conducted through MAS Rural Initiative and Narikeldaha PRAYAS. Services included symptom assessment, bedside nursing support, caregiver training, psychosocial counselling, advance-care discussions, and linkage to oncology services. Data were collected using service records, patient interviews, and caregiver feedback. A mixed-methods approach assessed service utilization, symptom relief, patient/caregiver satisfaction, and barriers to continuity of care. Equity indicators included gender, socioeconomic vulnerability, rural location, and diagnosis at presentation.
RESULTS:
Over 20 years, the program supported more than 2,500 patients—predominantly women with breast and gynecological cancers—through home visits and bedside care. Eighty-six percent of patients reported improved symptom control, and 78% of caregivers reported reduced distress following structured counselling and training. Integration with local hospitals increased treatment adherence, while community volunteers enabled continuous monitoring. Key barriers included transport costs, caregiver exhaustion, and social stigma; however, community trust and culturally sensitive counselling significantly improved early reporting and care-seeking behaviours.
CONCLUSIONS:
This low-cost, community-embedded bedside support model demonstrates that equitable, inclusive, and sustainable palliative care can be achieved in rural, resource-constrained settings. Scaling similar approaches could strengthen universal health coverage and reduce suffering among marginalized populations. The model offers a replicable pathway toward “Health Without Borders” by empowering communities to deliver compassionate, culturally aligned care where formal health systems are limited.
Rural communities in India face persistent inequities in access to palliative care, bedside support, and psychosocial services, especially among cancer patients and their families. Geographic isolation, poverty, lack of trained providers, and sociocultural stigma contribute to late presentation, unmanaged symptoms, and limited end-of-life support. To address these gaps, a community-driven bedside support model was implemented in East Medinipur District, West Bengal, integrating oncology social work, home-based palliative care, and patient advocacy.
METHODS:
A longitudinal community program (2005–2025) was conducted through MAS Rural Initiative and Narikeldaha PRAYAS. Services included symptom assessment, bedside nursing support, caregiver training, psychosocial counselling, advance-care discussions, and linkage to oncology services. Data were collected using service records, patient interviews, and caregiver feedback. A mixed-methods approach assessed service utilization, symptom relief, patient/caregiver satisfaction, and barriers to continuity of care. Equity indicators included gender, socioeconomic vulnerability, rural location, and diagnosis at presentation.
RESULTS:
Over 20 years, the program supported more than 2,500 patients—predominantly women with breast and gynecological cancers—through home visits and bedside care. Eighty-six percent of patients reported improved symptom control, and 78% of caregivers reported reduced distress following structured counselling and training. Integration with local hospitals increased treatment adherence, while community volunteers enabled continuous monitoring. Key barriers included transport costs, caregiver exhaustion, and social stigma; however, community trust and culturally sensitive counselling significantly improved early reporting and care-seeking behaviours.
CONCLUSIONS:
This low-cost, community-embedded bedside support model demonstrates that equitable, inclusive, and sustainable palliative care can be achieved in rural, resource-constrained settings. Scaling similar approaches could strengthen universal health coverage and reduce suffering among marginalized populations. The model offers a replicable pathway toward “Health Without Borders” by empowering communities to deliver compassionate, culturally aligned care where formal health systems are limited.
| eISSN: | 2654-1459 |
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