Development of Palliative Care for Children with Cancer in Iran: A Local Model

Abstract

Background: Palliative care is a fundamental component of cancer care for children. However, access to pediatric palliative care (PPC) remains limited in low- and middle-income countries. One of the major challenges in developing and implementing PPC is the lack of evidence-based models. Sharing practical experiences in establishing PPC services in various countries, including Iran, can provide valuable insights for similar healthcare settings. Objectives: This article aims to present the experiences and measures taken to establish and provide PPC at a major referral children's hospital in Iran, from inception to the present. Methods: This study reports on the experience of establishing an outpatient pediatric palliative care clinic based on the World Health Organization (WHO) framework between 2021 and 2024 at Mofid Children's Hospital in Tehran, Iran. Results: Following WHO guidelines, this project was implemented in 11 steps. Key challenges encountered during the process included stakeholder engagement, human resource shortages, training gaps, and service monitoring. The most effective solutions involved increasing knowledge and awareness about PPC, promoting formal and informal education, and leveraging support from charities and research institutions. Conclusions: The establishment of a PPC clinic at a national referral children's hospital and the documentation of its outcomes can serve as a model for expanding these services across Iran. Additionally, this model may be adapted for implementation in other countries facing similar challenges.