Sabah Cancer Society. The concept of palliative care gradually grew and spread to Penang and Kuala Lumpur. A great advance in this field was the establishment of the first palliative care unit which began its activity in 1995, at Queen Elizabeth Hospital, Kota Kinabalu. This center only provided palliative care at first, and its staff was officially trained in this field. In 1996, a workshop on palliative care was held at the hospital, which provided an opportunity to officially introduce palliative care. Finally, the government obliged all public hospitals to establish palliative care units by the year 2000.\[[@ref14]\]

In 1988, 14 hospice centers came together, in order to form a national association called the South African Hospice Association. In 2003, the name was changed to the Hospice Palliative Care1980s, hospice service developed as palliative care services throughout the country. The charity foundations along with National Cancer Institute and the Ministry of Health made some decisions through discussions, and in 1991, The National Council for Hospice and Specialist Palliative Care Services was established.\[[@ref20]\] Then regional executive groups were established and started designing and planning in their regions. In addition, protocols were developed for patient referral.

Formulating the imparted guidelines in Malaysia introduced two methods: first, the establishment of a unit in the form of a palliative care unit with at least six special beds and full-time nurses. In this regard, small hospitals can form palliative care teams with doctors and nurses to provide palliative care throughout the hospital, but without special beds. An evaluation of palliative care services