ArticleDiabetic medicine : a journal of the British Diabetic Association2022
Management of type 1 diabetes in low- and middle-income countries: Comparative health system assessments in Kyrgyzstan, Mali, Peru and Tanzania.
Article in Diabetic medicine : a journal of the British Diabetic Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- The transition of youth with diabetes from paediatric to adult diabetes care services: a consensus report of the joint working group of the International Society for Pediatric and Adolescent Diabetes (ISPAD), the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA).Hormone research in paediatrics · 2026Article
- Article
- Feasibility and acceptability of e-learning training about diabetes and insulin usage to Peruvian healthcare professionals.BMJ open quality · 2026Article
- Implementation and evaluation of an insulin use manual in the public health system of a Peruvian Region: a mixed-methods study.BMC medical education · 2026Article
- Automated Insulin Delivery in Pregnancy With Type 1 Diabetes: An Integrative Review of Clinical Evidence, Socio-Technical Implementation and Equity.Journal of diabetes research · 2026Review
- Adaptation of an mHealth Solution for the Nutritional Management of Diabetes in a Low- and Middle-Income Country: Pre-Post Mixed Methods Pilot Study.JMIR mHealth and uHealth · 2025Article
- Models of care for children and adolescents with type 1 diabetes in low- and middle-income countries: a scoping review.The Cochrane database of systematic reviews · 2025Article
- Achieving impactful treatment for paediatric endocrine disorders in low- to middle-income countries (LMICs): a scoping review.BMJ open · 2025Article
- Adapting and Accepting Type 1 Diabetes: A Qualitative Exploration of the Perspectives from People with Type 1 Diabetes from 13 Countries.Healthcare (Basel, Switzerland) · 2025Article
- Article
- Availability, prices and affordability of self-monitoring blood glucose devices: surveys in six low-income and middle-income countries.BMJ public health · 2025Article
- Article
- Availability, price and affordability of insulin, delivery devices and self-monitoring blood glucose devices in Indonesia.PloS one · 2024Article
- Rapid methods for identifying barriers and solutions to improve access to community health services: a scoping review.BJGP open · 2023Article
- Determinants of Self-monitoring of Blood Glucose in Iranian Children and Adolescents with Type 1 Diabetes.International journal of endocrinology and metabolism · 2023Article
- Management of type 1 diabetes in low- and middle-income countries: Comparative health system assessments in Kyrgyzstan, Mali, Peru and Tanzania.Diabetic medicine : a journal of the British Diabetic Association · 2022Article
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Authors and funding
18 authors.
Funding
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Abstract
aimsTo describe and compare the health system responses for type 1 diabetes in Kyrgyzstan, Mali, Peru and Tanzania.
methodsThe 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.
resultsDespite 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.
conclusionsPeople 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.
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