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Figure 1. Health technology assessment: a tool to inform decision-makers in support of 
UHC
Source: 
http://www.who.int/health-technology-assessment/about/en/
Fragile states
HTA, define
Essential services
Emergency kits
Disaster planning
Low-income countries
with low coverage
HTA, define
Primary health
care packages
Middle-income
countries with low
coverage
HTA, define
Guaranteed packages
of care
Strong health
system
HTA, define
Marginal analysis
for additions to
packages
Health systems
Continuum of HTA activities

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51
A WHO guide for planners, implementers and managers
All providers of palliative care, whatever the care setting, should be committed to continuous improvement 
of the quality of their services. Data collected from quality indicators are a primary source of information for 
improving services. A basic framework for indicators that can be used to assess the key domains of national 
or regional programmes is described in Table 4. 
Table 4. Sample indicators for assessing enhanced access to palliative care in PHC
Category
Indicator
Policy
Existence of a current national palliative care policy that requires access for all to palliative care and 
to pain control with opioid pain medicines (yes/no)
Existence of a current national palliative care strategic plan to create access for all within a speci-
fied time period to palliative care and to pain control with opioid pain medicines (yes/no)
Existence of current national policies or strategic plans that promote access to palliative care and to 
opioid analgesia on the following topics:
n
primary health care (yes/no)
n
cancer (yes/no)
n
noncommunicable diseases (yes/no)
n
older persons (yes/no)
n
paediatrics (yes/no)
n
HIV/AIDS (yes/no)
n
drug-resistant tuberculosis (yes/no)
Essential Package of Palliative Care for Primary Health Care included in universal health coverage 
(yes/no)
Laws and regulations in place for safe and effective opioid prescribing in line with international 
drug conventions at the district level? (yes/no) 
At the community level? (yes/no) 
Education
Proportion of medical schools that include palliative care education in undergraduate curricula 
(ratio of medical schools with palliative care at the undergraduate level to total medical schools)
Proportion of nursing schools that include palliative care education in undergraduate curricula 
(ratio of nursing schools with palliative care at the undergraduate level to total nursing schools)
Proportion of medical technical schools (for training clinical officers, assistant doctors, nurse prac-
titioners or feldshers) that include palliative care education in undergraduate curricula (ratio of 
medical technical schools with palliative care to total medical technical schools)