Projects
Introduction:
The aim of the IIF is to study the problems that patients face accessing proper care and insulin for their diabetes in developing countries. In order to study the barriers to access, the IIF developed the Rapid Assessment Protocol for Insulin Access (RAPIA). The RAPIA provides a practical field guide to assist teams in the collection, analysis and presentation of data to evaluate and inform the development of health care services for diabetes management in low and middle income countries. The development of the RAPIA was made possible with the financial support of the World Diabetes Foundation (Pilot in Mozambique), WHO and Diabetes Foundation (work in Zambia), Diabetes Foundation (work in Mali), a collaboration with Handicap International (work in Nicaragua) and support of the IDF (Vietnam and Kyrgyzstan).
The RAPIA is structured as a multi-level assessment of the different elements that influence the access patients have to insulin and diabetes care in a given country. The framework of the RAPIA studies the path of insulin from its arrival in the country to the point that it reaches or fails to treat the patient effectively and thereby identify how and where the system works and/or fails. This approach to the evaluation of health care services draws on the principles of Rapid Assessment Protocols (RAP) which have been developed and implemented in different areas. The method of RAP has been used extensively to assess services for communicable diseases, including malaria, tuberculosis and STDs, for the purpose of developing interventions. The approach chosen here is to adapt existing protocols to suit the assessment of access to insulin.
The main principles of the RAPIA are:
In order to achieve the broad aim, the RAPIA has the following objectives:
Structure:
The RAPIA is a series of questionnaires aimed at the following people within a country:
Results:
Information will be collected, analysed and discussed to develop policy recommendations to identify and remove the barriers that hinder accessibility of Insulin to all those who need it.Depending on the information gained during the RAPIA process, the measures for implementation can include:
The aim of the IIF is to study the problems that patients face accessing proper care and insulin for their diabetes in developing countries. In order to study the barriers to access, the IIF developed the Rapid Assessment Protocol for Insulin Access (RAPIA). The RAPIA provides a practical field guide to assist teams in the collection, analysis and presentation of data to evaluate and inform the development of health care services for diabetes management in low and middle income countries. The development of the RAPIA was made possible with the financial support of the World Diabetes Foundation (Pilot in Mozambique), WHO and Diabetes Foundation (work in Zambia), Diabetes Foundation (work in Mali), a collaboration with Handicap International (work in Nicaragua) and support of the IDF (Vietnam and Kyrgyzstan).
The RAPIA is structured as a multi-level assessment of the different elements that influence the access patients have to insulin and diabetes care in a given country. The framework of the RAPIA studies the path of insulin from its arrival in the country to the point that it reaches or fails to treat the patient effectively and thereby identify how and where the system works and/or fails. This approach to the evaluation of health care services draws on the principles of Rapid Assessment Protocols (RAP) which have been developed and implemented in different areas. The method of RAP has been used extensively to assess services for communicable diseases, including malaria, tuberculosis and STDs, for the purpose of developing interventions. The approach chosen here is to adapt existing protocols to suit the assessment of access to insulin.
The main principles of the RAPIA are:
- Speed – the methods are intended to provide relevant information quickly, upon which decisions about health care interventions can be made.
- Use of multiple data sources – different methods are used to access different sources of data to get a balanced overview.
- Pragmatism – the methods should provide adequate information, without necessarily being ‘scientifically perfect’. Triangulation, or cross-checking between different sources of data is used to establish the validity and reliability of the data collected.
- Cost-effectiveness – the focus is on research instruments that provide information cheaply, and are not labour and time intensive. Where possible, use is made of existing data.
In order to achieve the broad aim, the RAPIA has the following objectives:
- To provide a range of data collection tools, from which research teams can select those appropriate to their own situation;
- To provide suggestions of data items to collect;
- To provide suggestions on data sources, data collection, data analysis and data presentation for each of the tools presented.
Structure:
The RAPIA is a series of questionnaires aimed at the following people within a country:
- Ministry of Finance
- Ministry of Trade
- Ministry of Health
- Private Sector
- National Diabetes Association
- Central Medical Store
- Educators
- Regional/District Health Organisation
- Hospitals, Clinics, Health Centres and Dispensaries
- Pharmacy/Drug dispensaries
- Laboratories
- Health workers
- Traditional doctors
- Patients
Results:
Information will be collected, analysed and discussed to develop policy recommendations to identify and remove the barriers that hinder accessibility of Insulin to all those who need it.Depending on the information gained during the RAPIA process, the measures for implementation can include:
- Supporting countries to tender for bulk purchase of reliable sources of Insulin at the lowest cost;
- Assistance in distribution of Insulin in countries;
- Assistance in establishing and implementing Essential Drug Policies;
- Advice on revision of local tax regulations for Essential Drugs;
- Support for good practice in storage and distribution of Insulin;
- Improving availability of Insulin syringes and monitoring equipment;
- Dissemination of educational programmes for managing Type 1 Diabetes by health workers at regional, district and primary health care level, and by patients and their families;
- Collection of reliable information on prevalence and morbidity of Type 1 Diabetes in these countries
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© International Insulin Foundation - Registered Charity No. 1099032
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© International Insulin Foundation - Registered Charity No. 1099032
