# Volunteer-led neighbourhood palliative networks, the Kerala model, adapted elsewhere

Source: https://onco.cc/ideas/idea-acc-neighbourhood-palliative-networks/  
OnCo record `idea-acc-neighbourhood-palliative-networks` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- 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.
- Proposed 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

## Sources

- Bottleneck evidence (Pain relief and palliative care are unavailable to most): WHO fact sheet, Palliative care: https://www.who.int/news-room/fact-sheets/detail/palliative-care

## Connected records

- ideas: [Community health workers trained in cancer triage, navigation and home palliative care](https://onco.cc/ideas/idea-acc-community-health-workers-oncology/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Not enough oncologists, nurses, pathologists, physicists](https://onco.cc/bottlenecks/b-workforce/), [Pain relief and palliative care are unavailable to most](https://onco.cc/bottlenecks/b-palliative/)

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