{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T08:31:39Z","timestamp":1787041899500,"version":"build-2736575974"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Palliative 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Narrative 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cuba 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cuba 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\u20132028 represents an important opportunity. Explicit alignment with the WHO model, strengthening specialized training, and generation of national scientific evidence are recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1908007","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T08:23:17Z","timestamp":1787041397000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Palliative care for children with cancer in Cuba: a narrative review and adaptation of the World Health Organization integration model"],"prefix":"10.3389","volume":"14","author":[{"given":"Mariuska","family":"Forteza S\u00e1ez","sequence":"first","affiliation":[{"name":"Pediatric Oncology Service, Institute of Oncology and Radiobiology (INOR)","place":["Havana, Cuba"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria del Carmen","family":"Llant\u00e1 Abreu","sequence":"additional","affiliation":[{"name":"Psycho-Oncology Service, Institute of Oncology and Radiobiology (INOR)","place":["Havana, Cuba"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolainy","family":"Romero Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Service, Institute of Oncology and Radiobiology (INOR)","place":["Havana, Cuba"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dayne Clarivel","family":"Quintero V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Service, Institute of Oncology and Radiobiology (INOR)","place":["Havana, Cuba"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"B1","volume-title":"Cure All Framework: WHO Global Initiative for Childhood Cancer","year":"2021"},{"key":"B2","volume-title":"Anuario Estad\u00edstico de Salud 2023","year":"2024"},{"key":"B3","volume-title":"Integrating Palliative Care and Symptom Relief into Paediatrics: A WHO Guide for Health-care planners, Implementers and Managers","year":"2018"},{"key":"B4","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1056\/NEJMoa1000678","article-title":"Early palliative care for patients with metastatic non-small-cell lung cancer","volume":"363","author":"Temel","year":"2010","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1200\/JCO.2016.70.1474","article-title":"Integration of palliative care into standard oncology care: American society of clinical oncology clinical practice guideline update","volume":"35","author":"Ferrell","year":"2017","journal-title":"J Clin Oncol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1200\/JCO.18.02123","article-title":"Models of palliative care delivery for patients with cancer","volume":"38","author":"Hui","year":"2020","journal-title":"J Clin Oncol"},{"key":"B7","volume-title":"A Guide to the Development of Children\u2019s Palliative Care Services","year":"2009"},{"key":"B8","volume-title":"Atlas de Cuidados Paliativos de Latinoam\u00e9rica ALCP","author":"Pastrana","year":"2012"},{"key":"B9","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/j.jpainsymman.2025.07.026","article-title":"First-ever global ranking of palliative care: 2025 world, map under the new WHO framework","volume":"70","author":"Tripodoro","year":"2025","journal-title":"J Pain Symptom Manage"},{"key":"B10","doi-asserted-by":"publisher","first-page":"4","DOI":"10.35454\/rncm.v4n2.226","article-title":"Cuidados paliativos en Latinoam\u00e9rica","volume":"4","author":"Bonilla Sierra","year":"2020","journal-title":"Rev Nutr Clin Metab"},{"key":"B11","volume-title":"Proyecto Nacional de Implementaci\u00f3n de Cuidados Continuos y Cuidados Paliativos en Pacientes Oncopedi\u00e1tricos (MINSAPPRCP-OPD-2025-001)","year":"2025"},{"key":"B12","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1016\/S23524642(25)00374-8","article-title":"Controlled medicines for children\u2019s medical needs: a review of the scope, determinants, and consequences of inequitable access","volume":"10","author":"Maser","year":"2026","journal-title":"Lancet Child Adolesc Health"},{"key":"B13","volume-title":"Narcotic Drugs: Estimated World Requirements and Statistics","year":"2023"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1752","DOI":"10.1056\/NEJMra030334","article-title":"Pediatric palliative care","volume":"350","author":"Himelstein","year":"2004","journal-title":"N Engl J Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e401","DOI":"10.31134\/ap.93.2.33","article-title":"Desarrollo de los cuidados paliativos pedi\u00e1tricos en Uruguay, 2008-2020. 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