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Delivery of Type 2 diabetes care in low- and middle-income countries: lessons from Lima, Peru

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dc.contributor.author Cardenas, M. K.
dc.contributor.author Miranda, J. J.
dc.contributor.author Beran, D.
dc.date.accessioned 2019-02-06T14:45:11Z
dc.date.available 2019-02-06T14:45:11Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5038
dc.description.abstract AIMS: The health system's response is crucial to addressing the increasing burden of diabetes, particularly that affecting low- and middle-income countries. This study aims to assess the facilitators and barriers that help or hinder access to care for people with diabetes in Peru. METHODS: We used a survey tool to design and collect qualitative and quantitative data from primary and secondary sources of information at different levels of the health system. We performed 111 interviews in Lima, the capital city of Peru, with patients with diabetes, healthcare providers and healthcare officials. We applied the six building blocks framework proposed by the World Health Organization in our analysis. RESULTS: We found low political commitment, as well as several barriers that directly affect access to medicines, regular laboratory check-ups and follow-up appointments for diabetes, especially at the primary healthcare level. Three major system-level barriers were identified: (1) the availability of information at different healthcare system levels that affects several processes in the healthcare provision; (2) insufficient financial resources; and (3) insufficient human resources trained in diabetes management. CONCLUSION: Despite an initial political commitment by the Peruvian government to improve the delivery of diabetes care, there exist several key limitations that affect access to adequate diabetes care, especially at the primary healthcare level. In a context in which various low- and middle-income countries are aiming to achieve universal health coverage, this study provides lessons for the implementation of strategies related to diabetes care delivery. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartof urn:issn:1464-5491
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Aged en_US
dc.subject Biomedical Technology/statistics & numerical data en_US
dc.subject Clinical Governance en_US
dc.subject Diabetes Mellitus, Type 2/epidemiology/therapy en_US
dc.subject Health Services Accessibility/standards en_US
dc.subject Health Services/standards/supply & distribution en_US
dc.subject Health Workforce/statistics & numerical data en_US
dc.subject Humans en_US
dc.subject Hypoglycemic Agents/supply & distribution en_US
dc.subject Leadership en_US
dc.subject Middle Aged en_US
dc.subject Peru/epidemiology en_US
dc.subject Prevalence en_US
dc.subject Private Sector/statistics & numerical data en_US
dc.subject Public Sector/statistics & numerical data en_US
dc.subject Universal Health Insurance/statistics & numerical data en_US
dc.subject Young Adult en_US
dc.title Delivery of Type 2 diabetes care in low- and middle-income countries: lessons from Lima, Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1111/dme.13099
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.18
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.27


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