ISBN:
Read Improving Access to Diabetes Care for the Working Poor, Kenya: Health Systems Evaluation of Base of the Pyramid Project subtitle for free
50 books to read Improving Access to Diabetes Care for the Working Poor, Kenya: Health Systems Evaluation of Base of the Pyramid Project published by at 2017 is represented to you if you want book with category . 50 books to read composed by Shannon Geordan, with count of page Pages. you can found book content at here
Background:The Base of the Pyramid (BoP) project is a public-private partnership that aims to facilitate access to diabetes care for the working poor in LMICs. Initiated by Novo Nordisk, BoP uses hybrid models adapted to improve healthcare for people with diabetes at the base of the economic pyramid. In Kenya, the BoP brings together stakeholders to ensure: increased awareness of diabetes; early diagnosis of diabetes; access to quality care by trained health care professionals; stable and affordable insulin supply; and improved self-management through patient education. This study evaluates the extent to which BoP Kenya is scalable and sustainable, whether stakeholders share value in the Kenyan BoP, and whether BoP Kenya has improved access to diabetes care.Methods:The Rapid Assessment Protocol for Insulin Access (RAPIA), a health systems evaluation approach developed to provide a broad situational analysis of diabetes care, was used to examine health infrastructure and diabetes care pathways in Kenya. At national level, the RAPIA was applied in a SWOT analysis of the BoP through a total of fifteen in-depth interviews with key stakeholders.At individual and county health system levels, RAPIA was adapted to explore the impact of the BoP on access to diabetes care through a comparison of an intervention and control county. In the intervention county, Meru, 22 in-depth interviews and four focus group discussions (FGDs) were performed. In the control county, Trans Nzoia, matched on demographic and geographic features, 24 in depth interviews and two FGDs were performed. Data was collected from diabetic patients, medical staff, community health workers, pharmacists, lab technicians and heath service administrators.Results:The results presented here are preliminary findings.The BoP was implemented in 27 of 47 counties in Kenya. Meru, the intervention county, had 35 of 62 facilities (56.45%) participating in the BoP. There was some knowledge of the BoP at higher levels of hospital administration, but very little knowledge in smaller facilities or with individual staff members. The price of insulin was successfully controlled to around 500kSh (5 USD) in Faith-Based facilities and sold for less (around 200kSh, 2 USD, but was more frequently out of stock) at Government clinics. This situation was similar to Trans Nzoia county, which did not have the BoP formally implemented.Despite reduced insulin costs, many diabetic patients could not afford the additive expenses of regular monitoring, testing, medical consultations, medicines, seeking care and travel costs. Patients interviewed experienced competing financial priorities forcing a difficult choice between food, living expenses, education, and essential healthcare.At a national level, the majority of focus was placed upon ensuring insulin was available and affordable through national and local initiatives. This may reflect key roles and priorities of some stakeholders. Although it was recognised that holistic change was needed to improve diabetes care, the partner organisations at the top of the model had limited contact with and control over actions on the ground.Conclusion:In the context of rising prevalence of non-communicable diseases in LMICs, cross-sector approaches to improving access to diabetes care are increasingly needed. The BoP engaged stakeholders at a national level to ensure structural change, but needs to invest more in local approaches to overcoming barriers to care.Declaration on potential conflicts of interestThe authors declare no conflict of interest.Funding sources for researchThe evaluation of the Base of the Pyramid Program was funded by Novo Nordisk.
ENKyzQEACAAJ
Tags: great Improving Access to Diabetes Care for the Working Poor, Kenya: Health Systems Evaluation of Base of the Pyramid Project free download, well met book Improving Access to Diabetes Care for the Working Poor, Kenya: Health Systems Evaluation of Base of the Pyramid Project, Improving Access to Diabetes Care for the Working Poor, Kenya: Health Systems Evaluation of Base of the Pyramid Project google book