Palliative care coverage is fragmented in India. The vast majority of institutions treating cancer patients have no palliative care services. There are many states in India which do not have even a single palliative care facility.⁹⁵ Most palliative care services in India are concentrated in cities and urban areas which leaves vast geographical areas without provision. Only the state of Kerala can claim to have a comprehensive service provision where it is estimated that there is a 60-80% coverage in the northern districts.⁹⁶