Submission ID 131851
| Issue/Objective | Perinatal and neonatal palliative care (PNPC) remains underdeveloped in low- and middle-income countries (LMICs), despite a growing need driven by advances in neonatal care. Limited access to structured, multidisciplinary training leaves many providers underprepared to deliver coordinated palliative care. Project ECHO (Extension for Community Healthcare Outcomes) is a low-cost virtual education model designed to build capacity among healthcare providers in resource-limited settings. This study evaluates the impact of a pilot PNPC ECHO program and aligns with global efforts to advance equitable access to palliative care. |
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| Methodology/Approach | A 7-week virtual program was developed using the Fink integrated curriculum design model, incorporating a needs assessment, defined learning objectives, and interactive teaching strategies. Participants represented a multidisciplinary cohort across 13 countries (10 LMICs) including pediatricians, neonatologists, family medicine physicians, fetal medicine experts, obstetricians, and palliative care providers. Pre- and post-program surveys assessed participants' self-reported knowledge, attitudes and comfort using Likert scales, multiple choice, and open-ended questions, alongside demographic data. |
| Results | In the pre-program survey (n=51), most participants reported caring for 1-10 patients per month who might benefit from palliative care. While principles such as prioritising pain and symptom relief were well understood, there were significant gaps including associating palliative care with only end of life care. Participants also reported low confidence in opioid prescription, communication with families, and decision-making around life-sustaining treatment. Following program completion, meaningful improvements in knowledge and attitudes were demonstrated, especially with regards to PNPC delivery frameworks and the ethics of dealing with high intensity treatments. |
| Discussion/Conclusion | This study is the first to evaluate the Project ECHO for PNPC, an underserved aspect within pediatric palliative care. Findings confirm that a structured virtual education intervention can shift knowledge and attitudes in LMICs. Global North-South Collaboration that brings standardised training with contextual, resource-appropriate clinical guidance is essential to improve accessibility, a significant step in advancing global health equity and leadership. |
| Presenters and Affiliations | Smriti Khanna PD Hinduja Hospital and Medical Research Centre Kiran Shrivastava Reliance Foundation Hospital and Research Centre Spandana Rayala Two Worlds Cancer Collaboration Megan Doherty Faculty of Medicine, University of Ottawa Bernice Leung Queen's University |
