Palliative care is a critical component of end-of-life care for cancer patients in Libyan city hospitals, yet access to such services remains constrained by various healthcare sector challenges. A mixed-methods design combining qualitative interviews with quantitative surveys to evaluate service availability, quality of care, and patient-reported outcomes across five major Libyan city hospitals. Palliative care services were found to be available at only two out of the five surveyed hospitals, with a reported satisfaction rate among patients below 50% for pain management and emotional support interventions. While palliative care is recognised as essential in Libyan city hospitals, significant disparities exist in service availability and patient satisfaction levels, necessitating targeted improvements. Hospitals should prioritise expansion of palliative care services, with a focus on training healthcare providers to improve quality of care. Policy-makers must also address financial barriers that limit access to these critical resources. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.