Universidad Peruana Cayetano Heredia

Management of type 1 diabetes in low- and middle-income countries: Comparative health system assessments in Kyrgyzstan, Mali, Peru and Tanzania

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dc.contributor.author Abdraimova, A
dc.contributor.author Besancon, S
dc.contributor.author Portocarrero Mazanett, Jill Katherine
dc.contributor.author Ramaiya, K
dc.contributor.author Dunganova, A
dc.contributor.author Ewen, M
dc.contributor.author Hogerzeil, H
dc.contributor.author Lazo Porras, María de los Ángeles
dc.contributor.author Laing, R
dc.contributor.author Lepeska, M
dc.contributor.author Nchimbi, H
dc.contributor.author Sidibe, A
dc.contributor.author Swai, A
dc.contributor.author Tenorio Mucha, Janeth Marilyn
dc.contributor.author Yudkin, JS
dc.contributor.author Zafra-Tanaka, Jessica Hanae
dc.contributor.author Zurdinova, A
dc.contributor.author Beran, D
dc.date.accessioned 2022-06-25T20:36:43Z
dc.date.available 2022-06-25T20:36:43Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/11879
dc.description.abstract Aims: To describe and compare the health system responses for type 1 diabetes in Kyrgyzstan, Mali, Peru and Tanzania. Methods: The Rapid Assessment Protocol for Insulin Access, a multi-level assessment of the health system, was implemented in Kyrgyzstan, Mali, Peru and Tanzania using document reviews, site visits and interviews to assess the delivery of care and access to insulin. Results: Despite the existence of noncommunicable or diabetes strategies and Universal Health Coverage policies including diabetes-related supplies, this has not necessarily translated into access to insulin or diabetes care for all. Insulin and related supplies were often unavailable and unaffordable. Across the four countries test strips and insulin, when paid for by the individual, represented respectively 48–82% and 25–36% of total costs. Care was mainly delivered at tertiary-level hospitals by specialists. Only Kyrgyzstan had data collection systems integrated into the Ministry of Health structure. In addition, issues with healthcare worker training and education and empowerment of people with diabetes were present in these health systems. Conclusions: People with type 1 diabetes in these countries face different barriers, including the cost of insulin and care. Given the renewed attention to diabetes on the global health agenda tailored health system responses for type 1 diabetes are needed. Insulin should be prioritized as it is the foundation of type 1 diabetes care, but other elements of care and support need to be fostered by different actors. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartofseries Diabetic Medicine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject developing countries en_US
dc.subject health delivery of health care en_US
dc.subject insulin en_US
dc.subject type 1 diabetes en_US
dc.title Management of type 1 diabetes in low- and middle-income countries: Comparative health system assessments in Kyrgyzstan, Mali, Peru and Tanzania en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1111/dme.14891
dc.relation.issn 1464-5491


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