{"entity":{"id":"idea-acc-neighbourhood-palliative-networks","kind":"idea","name":"Volunteer-led neighbourhood palliative networks, the Kerala model, adapted elsewhere","aka":[],"tldr":"In Kerala, trained community volunteers, backed by nurses and doctors, provide most home palliative care to the dying. The model reaches more people at lower cost than any clinic-based service and could be copied.","summary":"The Neighbourhood Network in Palliative Care in Kerala trains community volunteers to identify patients, provide social and basic nursing support, and link to professional teams, with local government funding and a state palliative care policy. Coverage is far higher than elsewhere in India. Adapting this community-owned model in other states and countries requires local ownership, a light professional backbone, and reliable morphine supply rather than large budgets.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Pain relief and palliative care are unavailable to most): WHO fact sheet, Palliative care","url":"https://www.who.int/news-room/fact-sheets/detail/palliative-care"}],"tags":[],"related":["idea-acc-community-health-workers-oncology"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-palliative","b-global-access","b-workforce"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Districts adopting a neighbourhood network model will achieve palliative care coverage of at least 50% of people dying with cancer within four years, compared with under 10% for clinic-based services.","rationale":"Community mobilisation delivered coverage in Kerala where health-system approaches did not; the ingredients are documented and transferable.","test":"Implementation in ten districts across three countries with coverage, home-death rates where preferred, and caregiver-reported quality of dying as endpoints.","maturity":"being-tested-at-scale","actor":"patients","cost":"small","horizonYears":3},"route":"/ideas/idea-acc-neighbourhood-palliative-networks/","neighbours":{"idea":[{"id":"idea-acc-community-health-workers-oncology","kind":"idea","name":"Community health workers trained in cancer triage, navigation and home palliative care","route":"/ideas/idea-acc-community-health-workers-oncology/"}],"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-workforce","kind":"bottleneck","name":"Not enough oncologists, nurses, pathologists, physicists","route":"/bottlenecks/b-workforce/"},{"id":"b-palliative","kind":"bottleneck","name":"Pain relief and palliative care are unavailable to most","route":"/bottlenecks/b-palliative/"}]}}