Changing the World One Bedside at a Time

Project ECHO, launched in March 2025 by Indonesia’s Dharmais National Cancer Center, aims to strengthen the development of palliative care across the country by supporting and evaluating healthcare professionals trained in basic palliative care. Although more than 1,500 healthcare workers have completed intensive training programs in recent years, many continue to face barriers in implementing palliative care services. The ECHO model focuses on expanding workforce capacity, particularly in underserved areas, while addressing challenges such as opioid availability, institutional support, community attitudes, and clinical practice. The initiative supports Indonesia’s 2023 health law amendment, which formally commits the government to providing nationwide palliative care, though implementation plans and funding mechanisms remain unclear.

Despite progress, palliative care in Indonesia remains underdeveloped due to limited training capacity, weak institutional support, inadequate insurance reimbursement, and widespread misconceptions about palliative care and opioid use. Indonesia’s 2024 ImPACT study found that Dharmais Cancer Hospital is currently the country’s only fully operational palliative care unit, while tens of thousands of doctors and nurses still require training. Cultural stigma, fear of opioids, and reluctance among healthcare professionals to refer patients also continue to hinder access to care. Experts emphasize that broader education for healthcare providers, religious leaders, patients, and families is essential to improving acceptance and implementation. The ECHO program is expected to provide valuable data and ongoing support to accelerate the growth and quality of palliative care services nationwide.

Links:

• https://iahpc.org/what-we-do/communication/pallinews/2026/may-7/report-from-indonesia/