Estado actual del desarrollo de los cuidados paliativos en el cantón Portoviejo.

Abstract

Introduction: Palliative Care (PC) is essential to ensure a dignified life until the end; globally, only 14% of those who need it receive it. In Portoviejo, the implementation of this model faces structural challenges in light of the recent 2025 Organic Law. Objective: To evaluate the development of PC in Portoviejo Canton. Methods: Observational, descriptive, and cross-sectional research with a census-based design. The development of the system was assessed using the WHO "House of Palliative Care" model. Data collection was carried out through structured and validated questionnaires administered via digital forms. Statistical analysis included descriptive statistics. Results: A fragmented network was identified where only 17.8% of health units have PC teams, with an effective coverage of just 18.75% of patients in need. Access to medication is critical, with 0% availability of oral morphine at the primary level of care. Regarding training, local undergraduate programs exclude the subject as a core requirement. Despite awareness of the law, budgetary execution is at 0%, and local research is non-existent, with zero theses defended in five years. Conclusions: Portoviejo's current reality is that of a legally advanced but operationally incipient system, placing it at an "Initial Development Level." The profound disconnection between the regulatory framework and clinical practice violates the human right to comprehensive relief of suffering and respect for a dignified death.