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Mozambique was chosen as a pilot as it is a “Highly Indebted Poor Country” (HIPC). The World Bank has defined an HIPC on the basis that the demands on these countries for debt repayment heavily exceed their ability to generate income, and as a consequence, programmes of social investment including health are suffering.
Implementing the RAPIA in an HIPC was to see how a sustainable solution can be found to the issues of access to insulin and proper diabetes care under extreme conditions of scarce resources in the health sector.
The Project Coordinator together with a team of local interviewers carried out the RAPIA in Mozambique over a period of almost 2 months in collaboration with the Ministry of Health and Associação Moçambicana dos Diabéticos (AMODIA, Association of Mozambican Diabetics).
The initial step was to get the necessary questionnaires translated from the original English version to Portuguese. This was done as well as a back translation to verify comprehensibility.
A letter from the Ministry of Health was obtained in order to carry out the interviews.
Once this was done training of the interviewers began, using a small guide developed for this purpose. This training took place 3 half days and focused on:
- What the aims of the project were
- How to carry out interviews
- Getting familiar with the questionnaires
In parallel key people to interview were identified by local partners.
In total 76 interviews and approximately another 30 informal meetings and discussions were held in three distinct geographical areas in Mozambique - Maputo, Beira and Lichinga and their surroundings. These three areas were chosen by local stakeholders due to their geographical distribution and differences in economic situation.
Each interview had as its main aim to obtain the person's perspective on the problems faced by people with diabetes in Mozambique in gaining access to insulin and proper diabetes care, rather than seeking precise statistical information.
Certain documents such as past reports and publications of the Ministry of Health were also reviewed. These were either documents that were mentioned during interviews or documents found in the documentation centre and the Ministry of Health.
A debriefing session was held at the end of each week to discuss problems or observations that the team had made during their work.
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