Palliative Care in Humanitarian Settings: An International Survey on Perceived Importance and Readiness among Health Emergency Response Unit Delegates

Abstract Background Palliative care is recognised as an essential component of humanitarian health response, yet its delivery in field operations remains limited. This study assessed perceived importance, readiness to deliver, training needs, and operational barriers among Red Cross and Red Crescent Health Emergency Response Unit (ERU) delegates. Methods A cross-sectional, web-based survey (LimeSurvey) was conducted among health professionals with ERU deployment experience between 1 October and 31 December 2024. The questionnaire captured demographics, background, preparedness, barriers, and training preferences. Descriptive statistics summarised categorical variables, and free-text responses underwent content analysis by two reviewers. Quantitative and qualitative data were analysed separately and integrated during interpretation. Results Of 173 responses, 114 met inclusion criteria ((11) ≥50% completion). Half (50.9%) had over ten years of humanitarian experience. Most (71.1%) considered palliative care extremely important, yet only 49.1% reported providing it, usually limited to pain relief; 25.4% reported none. Barriers included insufficient time or resources (56.1%), lack of training (49.1%), absent policies (48.2%), cultural barriers (47.4%), limited knowledge (36.8%), and restricted opioid access (28.1%). Among prescribers, 85.1% felt comfortable prescribing opioids, but stockouts (54.2%) and regulations (44.9%) constrained use. Most delegates (75.4%) had delivered bad news without structured communication training. Overall, 82.7% reported no palliative care training, although 91.4% endorsed dedicated blended learning combining online and practical components. Conclusions ERU delegates view palliative care as essential yet under-implemented. Integrating core competencies, standard protocols, and medicine access pathways—supported by competency-based training—could strengthen humanitarian readiness and support the integration of palliative care within EMT standards.