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health worker
Pain management
Conduct pain assessments
x
x
x
x
Treat mild, moderate and severe pain using chronic pain management 
guidelines, including oral morphine
x
x
x
Teach the patient and caregiver how to give pain medicine, including oral 
morphine
x
x
x
x
Prevent, recognize and treat the side-effects of pain medications
x
x
x
Advise on non-pharmacological methods of controlling pain
x
x
x
x
Treat extreme, non-responsive pain appropriately, including through the 
use of steroids where indicated
x
x
Symptom management
Manage other common symptoms (weight loss, nausea, fever, diarrhoea, 
trouble sleeping, anxiety etc.)
x
x
x
Psychosocial support and end-of-life care
Counselling, psychosocial and spiritual support
x
x
x
x
Support for patient at end of life
x
x
x
x
Support for caregivers, family members and children
x
x
x
x
Supervision
Supervise non-physician clinicians, nurses and community health workers 
in above activities
x
Supervise nurses and community health workers in above activities
x
x
Supervise community health workers in above activities
x
x
x
Source: WHO 2016 (3).
When task shifting, it is crucial that supervision be provided regularly and be continually available to 
maintain a high quality of care.

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37
A WHO guide for planners, implementers and managers
Box 2. North-east Thailand: palliative care integrated into 
PHC
Thailand has a three-tiered public health care system: primary care units; district hospitals; and provincial hospitals. Of the 
population, 99% is covered through a universal health insurance. Thailand’s exceptionally good record in health and human 
development is based on heavy investment in health infrastructure, particularly PHC, and on extending financial risk protection 
to the poor and vulnerable, public and private sector employees, and those engaged in the informal economy 
(77,78). In north-
east Thailand, the Ministry of Public Health has developed a network of nurse-led palliative home care teams within the public 
health care system. A Palliative Care Training Centre in a university hospital trains and organizes the nurse-led home care teams 
that are then based at the provincial hospitals, district hospitals and primary care units (community health centers/CHCs). After 
a successful pilot project, the programme was extended throughout north-east Thailand encompassing 20 provincial hospitals, 
300 district hospitals and more than 3000 CHCs. The home care teams are supervised by palliative care units that now exist in 
95% of the district hospitals. The palliative care units in district hospitals link with the palliative care units at the provincial 
hospital and with the CHCs 
(78). This success was possible because of the existence of:
n
a strong PHC network;
n
a national programme for UHC; and
n
an effective training programme at a palliative care training centre.