Universidad Peruana Cayetano Heredia

IDF2022-0946 Access to insulin and diabetes care from the stakeholder’s perspective in 3 regions of a low-and middle-income country

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dc.contributor.author Busta Flores, Patricia Janet
dc.contributor.author Lazo Porras, María de los Ángeles
dc.contributor.author Tenorio Mucha, Janeth Marilyn
dc.contributor.author Zafra-Tanaka, Jessica Hanae
dc.contributor.author Cárdenas García-Santillán, María Kathia
dc.date.accessioned 2023-04-16T04:38:14Z
dc.date.available 2023-04-16T04:38:14Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/13383
dc.description.abstract Background: All people with type 1 diabetes and 30% of people with type 2 diabetes require insulin to live. Nonetheless, access to insulin is not warranted. Health authorities and workers; caregivers and patients; all experience challenges and limitations to acquire, provide and use insulin. Also, the COVID-19 pandemic worsened these constraints, hampering access to insulin and diabetes care in low-and middle- income countries (LIMCs). Aim: To explore the perspectives from the macro, meso and micro level stakeholders regarding access to insulin and diabetes care in Peru. Method: A qualitative study was conducted in 3 geographically diverse regions. Fifty-five interviews were performed by telephone from February 18 to May 14, 2021; with key stakeholders such as health authorities, primary care workers, caregivers and patients. The Rapid Assessment Protocol for Insulin Access (RAPIA) methodology was used to explore health system structure; Policy background; Financing; Data collection and information systems; Healthcare workers; Patient empowerment; and Community participation. Results: Only few facilities at the primary health level (PHC) can treat patients who require insulin. The lack of supplies for glucose tests is frequent at PHC, as well as the insufficient skills of health workers to provide adequate management. Although there are clinical practice guidelines at the national level, they are not adequate for PHC. Hospital workers reported inadequate budget allocation. Some hospitals do not have endocrinologists, burdening internal medicine and general practitioners. Patient education varies greatly between the level of care: hospital vs. PHC. Access to a glucometer for self-monitoring at home varies greatly between regions and patients need help from caregivers to operate the glucometer. Almost all patients informed they had not received information about hypoglycemia and how to manage it. Conclusion: Overall, stakeholders responses reflect the needs and constraints of a LMIĆs health system regarding access to insulin and diabetes care. These should be considered when designing future interventions. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Diabetes Research and Clinical Practice
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject IDF2022-0946 en_US
dc.subject insulin en_US
dc.subject diabetes care en_US
dc.subject low income country en_US
dc.subject middle income country en_US
dc.title IDF2022-0946 Access to insulin and diabetes care from the stakeholder’s perspective in 3 regions of a low-and middle-income country en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.diabres.2023.110488
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.18
dc.relation.issn 1872-8227


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