almost simultaneously in the late 1980s and early 1990s, the formulation of policy documents has been considered by policy-makers. However, the issue of debate is who is responsible of such cares in these three countries, which indicates several differences; in the UK, the Ministry of Health, as the major care provider has fulfilled its dominant role in providing care. The UK government is also responsible for setting the main framework for formulation, planning, and implementation of these care services, as one of its main tasks, and has also ensured the proper geographical distribution of hospices, and official recognition of palliative medicine, and has determined the areas under coverage, in accordance with the situation. However in Malaysia, unlike the UK, the government sector has taken charge of these serviceswith a delay, under the influence of activities of other sectors involved in the health sector, by holding a national conference and formulating official guidelines for public hospitals. In South Africa, the major policy-maker and formulator is the HPCA of South Africa, formed by a joint of 14 hospice centers. After the needs of hospitals being identified, the integrated community-based home care program has been approved as the executive arm of this association and in collaboration with other organizations and has become a basis for such policies.

In the field of policy implementation, in the UK, despite the strong role of public sector and centralized decision-making and policy-making, there is a widespread, and in some cases, higher participation of other sectors, including voluntary sectors, in providing and funding services.