abstract: 'Objective: An enormous need for pediatric palliative care (PPC) has been

  reported, especially in low- and middle-income countries (LMICs).

  However, the access to PPC is limited. This study identifies the current

  challenges in the provision of PPC and their severity from the

  perspective of healthcare professionals. Method: We conducted a

  web-based descriptive cross-sectional survey among healthcare

  professionals treating children in need of palliative care in Mexico in

  2019. We used convenience sampling and snowball sampling to acquire

  participants. Results: Seventy healthcare professionals from Mexico

  participated. Participants were 64.3\% female, on average 45.8 (SD =

  10.9) years old, had an average of 15.84 (SD = 10.4) years of work

  experience and worked in 15 states. The three most severe barriers

  reported were: (1) Few teams and/or networks of out-of-hospital/domestic

  support; (2) Absence of training centres and continuing

  medical/paramedical education in PPC; and (3) Lack of legal, labor, and

  economic protection for parents who must stop working to be with their

  children. The barriers related to a lack of awareness and commitment, a

  lack of support, legal factors, and working conditions were rated

  highest. Participants considered increased awareness and better

  knowledge of PPC for all as the top priority, and particularly

  emphasized the need for better education and training of health

  professionals. Conclusion: We have identified several barriers to

  successful palliative care (PC) provision for children. Primarily, these

  are lack of awareness and commitment, especially of the health

  authorities and the medical professions, lack of personal and financial

  support, legal factors, and working conditions. The need to change and

  improve care exists at the policy level, the health professional level,

  and the public societal level.'
affiliation: 'Gruneberg, ES (Corresponding Author), Rhein Westfal TH Aachen, Med Fac,
  Dept Palliat Med, Seefeld 32, D-23843 Bad Oldesloe, Germany.

  Grueneberg, Elena Solveig; Pastrana, Tania, Rhein Westfal TH Aachen, Aachen, Germany.

  Ramos-Guerrero, Jorge, Univ Guadalajara, Jalisco, Mexico.'
article-number: 08258597211062767
author: Grueneberg, Elena Solveig and Ramos-Guerrero, Jorge and Pastrana, Tania
author-email: elena.grueneberg@rwth-aachen.de
author_list:
- family: Grueneberg
  given: Elena Solveig
- family: Ramos-Guerrero
  given: Jorge
- family: Pastrana
  given: Tania
da: '2023-09-28'
doi: 10.1177/08258597211062767
earlyaccessdate: DEC 2021
eissn: 2369-5293
files: []
issn: 0825-8597
journal: JOURNAL OF PALLIATIVE CARE
keywords: 'health services accessibility; pediatric palliative care; Mexico;

  children; adolescent; barrier; challenge; low- and middle-income

  countries'
keywords-plus: CHILDREN; CANCER; NEED; DISPARITIES; ARGENTINA; SERVICES; ACCESS
language: English
month: 2021 DEC 13
number-of-cited-references: '31'
orcid-numbers: Pastrana, Tania/0000-0002-1294-9657
papis_id: 0b1083308075a295bfcf1e48578a942c
ref: Grueneberg2021challengesprovision
researcherid-numbers: Pastrana, Tania/W-5069-2017
times-cited: '0'
title: 'Challenges in the Provision of Pediatric Palliative Care in Mexico: A Cross-Sectional
  Web-Based Survey'
type: Article; Early Access
unique-id: WOS:000730360900001
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
web-of-science-categories: 'Health Care Sciences \& Services; Health Policy \& Services;
  Public,

  Environmental \& Occupational Health'
year: '2021'