Cuba maintains a solid normative basis for pediatric palliative care despite identified gaps in trainingCuba Develops Better Palliative Care for Children with Cancer

Frontiers in Medicine Published August 18, 2026 DOI ↗ Editorial oversight: Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

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Key Takeaway

Note that while Cuba has a strong normative basis for PPC, gaps remain in staff training and home opioid access.

This narrative review evaluates the current landscape of pediatric palliative care (PPC) for children with cancer in Cuba. The analysis utilizes the WHO integration model to assess existing infrastructure, policy frameworks, and clinical gaps within the Cuban healthcare system.

The authors find that Cuba possesses a solid normative basis for PPC, supported by Ministerial Resolution No. 261/2020 and the National Cancer Control Program. Additionally, universal primary care coverage through the family doctor system facilitates continuity of care. However, several critical gaps were identified: these include a need for specialized staff training, improved equitable access to opioids at home, formal constitution of PPC teams in all eight centers, and an increase in published clinical research on outcomes.

A noted limitation is that the specific level of formal palliative care training among family physicians has not been systematically documented. The scope of this review is limited specifically to pediatric oncology; therefore, the needs of children with non-oncological life-limiting conditions are not addressed. These findings suggest opportunities for strengthening PPC through the National Pediatric Palliative Care Project 2026-2028 and alignment with WHO models.

How this fits prior evidence

This narrative review addresses a gap in the specific infrastructure and policy framework of pediatric palliative care in Cuba. While prior coverage noted that wasting is associated with higher chemotherapy toxicity and reduced survival in pediatric cancer patients, this review focuses on the systemic delivery of palliative support for those same patients. It provides context on the availability of opioid access and specialized training within the Cuban system.

This review looked at the current state of pediatric palliative care (PPC) for children with cancer in Cuba. The goal was to see how well these services align with global standards from the World Health Organization. The study found that Cuba already has a strong legal foundation and a universal family doctor system to help provide consistent care.

However, several areas need improvement to better serve young patients. These include training for specialized staff, making sure families can get enough pain medication at home, and forming official palliative care teams in all regional centers. There is also a need for more published research on patient outcomes.

Because this was a narrative review of current systems rather than a clinical trial, the results are not intended to change immediate medical practice. The findings highlight specific areas where Cuba can strengthen its programs through upcoming national projects. These improvements aim to provide better support and more consistent care for children facing serious illnesses.

What this means for you:

Cuba has a strong foundation for pediatric palliative care but needs more staff training and easier access to opioids.

Common questions

What are the main goals of improving pediatric palliative care?

The goal is to strengthen care by addressing specific gaps. These include providing better training for specialized staff, ensuring families have equitable access to opioids at home, and forming official palliative care teams in all eight centers. These steps aim to align local care with World Health Organization models.

How is cancer care currently organized for children in Cuba?

Cuba has a solid normative basis for pediatric palliative care, including the National Cancer Control Program and Ministerial Resolution No. 261/2020. The system also uses a universal family doctor system to help ensure that care remains continuous for the patients.

What specific gaps were found in current cancer care?

The review identified several areas for improvement: training for specialized staff, ensuring families can get enough pain medication at home, and a lack of published clinical research on outcomes. Additionally, formal palliative care teams are not yet established in all eight centers.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedAug 2026

View Original Abstract ↓

BackgroundPalliative care for children with cancer represents an urgent health priority in Cuba. The country has a universal and free health system with national coverage, but the systematic provision of specialized pediatric palliative care (PPC) in oncology remains heterogeneous, with significant gaps across the eight pediatric oncology reference centers.ObjectiveTo describe the state of PPC development for children with cancer in Cuba, analyze it through the lens of the simultaneous integration model proposed by the World Health Organization (WHO), and identify gaps and opportunities for strengthening. This review is intentionally limited to pediatric oncology; PPC needs of children with non-oncological life-limiting conditions fall outside its scope.MethodsNarrative review of scientific literature published between 2000 and 2024, normative documents of the Cuban Ministry of Public Health (MINSAP), and reports from international organizations (WHO, PAHO, IAHPC, ALCP). Two authors independently screened identified records; disagreements were resolved by discussion with a third author. The WHO analytical framework for PPC integration was applied to evaluate six key dimensions: policy, education, medicines, services, research, and financing.ResultsCuba has a solid normative basis for PPC, including Ministerial Resolution No. 261/2020 and the National Cancer Control Program. Primary care coverage is universal, and the family doctor system facilitates care continuity, though the current level of formal PC training among family physicians specifically has not been systematically documented. Gaps were identified in: specialized staff training, equitable access to opioids at home, formal constitution of PPC teams in all eight centers, and published clinical research on outcomes in this population.ConclusionsCuba has favorable structural conditions for implementing an integrated, high-quality PPC model for children with cancer. The implementation of the National Pediatric Palliative Care Project 2026–2028 represents an important opportunity. Explicit alignment with the WHO model, strengthening specialized training, and generation of national scientific evidence are recommended.

Cuba maintains a solid normative basis for pediatric palliative care despite identified gaps in trainingCuba Develops Better Palliative Care for Children with Cancer

How this fits prior evidence

Common questions

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Cuba maintains a solid normative basis for pediatric palliative care despite identified gaps in trainingCuba Develops Better Palliative Care for Children with Cancer

How this fits prior evidence

Common questions

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