M K Cardenas1, J J Miranda1,2, D Beran3. 1. CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru. 2. Department of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru. 3. Geneva University Hospitals and University of Geneva, Division of Tropical and Humanitarian Medicine, Geneva, Switzerland.
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.
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.
Authors: Maria Felix Torres-Nolasco; Eloy F Ruiz; Carla Tarazona-Meza; María Lazo-Porras; Germán Málaga Journal: J Int Med Res Date: 2022-06 Impact factor: 1.573
Authors: Maria Lazo-Porras; Silvana Perez-Leon; Maria Kathia Cardenas; M Amalia Pesantes; J Jaime Miranda; L Suzanne Suggs; François Chappuis; Pablo Perel; David Beran Journal: Glob Health Action Date: 2020-12-31 Impact factor: 2.640
Authors: David Beran; Maria Lazo-Porras; Maria Kathia Cardenas; François Chappuis; Albertino Damasceno; Nilambar Jha; Tavares Madede; Sarah Lachat; Silvana Perez Leon; Nathaly Aya Pastrana; Maria Amalia Pesantes; Suman Bahadur Singh; Sanjib Sharma; Claire Somerville; L Suzanne Suggs; J Jaime Miranda Journal: BMJ Glob Health Date: 2018-11-16
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